Sharma Piyush, Karthik N, Badkur Mayank, Elhence Poonam, Kobade Sarika P, Garg Pawan, Puranik Ashok, Paras Vaishali, Kevadiya Sanket, Sharma Naveen
General Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND.
Pathology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND.
Cureus. 2025 Jun 30;17(6):e87035. doi: 10.7759/cureus.87035. eCollection 2025 Jun.
Necrotising soft tissue infection (NSTI) is uncommon, and its management is complex due to its diverse clinical presentations, multiple associated comorbidities, and a wide range of potential microbial aetiologies. This study aims to illustrate the clinical profile, microbiological spectrum, and factors affecting mortality among patients with NSTI.
This single-centre, hospital-based, prospective observational study included all patients with NSTI aged 18 years or older. The primary outcome was the impact of time to surgery on mortality. Secondary outcomes included identifying the aetiology, microbiological flora, major co-morbidities, and overall outcomes in these patients. Results: During the study period, 87 patients were enrolled. There were 65 (74.7%) male and 22(25.3%) female patients with an age range of 18 years to 88 years. Postoperatively, 18 patients succumbed to death, while 69 survived. Overall, the average timing of the first intervention after admission was six hours, with no significant statistical difference between the survivor and non-survivor group (p-value = 0.575). Our study found types I and II infections in 26 (34.5%) and 45 (65.4%) patients, respectively, and )was the most common isolate in both types. The antibiotic resistance pattern revealed increased resistance to third-generation cephalosporins and fluoroquinolones for the group and .
High APACHE II and LRINEC scores, anaemia, hypoalbuminemia, and high creatinine are associated with a higher risk of death. Prompt multidisciplinary management of these patients significantly improves outcomes and reduces mortality.
坏死性软组织感染（NSTI）并不常见，由于其临床表现多样、多种合并症以及广泛的潜在微生物病因，其治疗较为复杂。本研究旨在阐述NSTI患者的临床特征、微生物谱以及影响死亡率的因素。
本单中心、基于医院的前瞻性观察性研究纳入了所有18岁及以上的NSTI患者。主要结局是手术时间对死亡率的影响。次要结局包括确定这些患者的病因、微生物菌群、主要合并症以及总体结局。结果：在研究期间，共纳入87例患者。其中男性65例（74.7%），女性2例（25.3%），年龄范围为18岁至88岁。术后，18例患者死亡，69例存活。总体而言，入院后首次干预的平均时间为6小时，存活组和非存活组之间无显著统计学差异（p值=0.575）。我们的研究发现，I型和II型感染分别发生在26例（34.5%）和45例（65.4%）患者中，并且都是这两种类型中最常见的分离株。抗生素耐药模式显示，该组对第三代头孢菌素和氟喹诺酮类药物的耐药性增加。
高APACHE II和LRINEC评分、贫血、低白蛋白血症和高肌酐与较高的死亡风险相关。对这些患者进行及时的多学科管理可显著改善结局并降低死亡率。
