The microbiology of necrotizing soft tissue infections

Elliott, David; Kufera, Joseph A.; Myers, Roy A.M.

doi:10.1016/s0002-9610(00)00360-3

Cited by 310 publications

(245 citation statements)

References 29 publications

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“…Necrotizing soft tissue infections are typically polymicrobic. In one retrospective study of 196 patients, nearly half had mixed aerobic and anaerobic growth, and Bacteroides species were the most common organisms isolated (84). In our studies, Bacteroides was not the most common anaerobic organism isolated; nevertheless, 7% of the anaerobes belonged to the B. fragilis group (299).…”

Section: Infections In Adultsmentioning

confidence: 45%

Bacteroides: the Good, the Bad, and the Nitty-Gritty

2007

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SUMMARY Summary: Bacteroides species are significant clinical pathogens and are found in most anaerobic infections, with an associated mortality of more than 19%. The bacteria maintain a complex and generally beneficial relationship with the host when retained in the gut, but when they escape this environment they can cause significant pathology, including bacteremia and abscess formation in multiple body sites. Genomic and proteomic analyses have vastly added to our understanding of the manner in which Bacteroides species adapt to, and thrive in, the human gut. A few examples are (i) complex systems to sense and adapt to nutrient availability, (ii) multiple pump systems to expel toxic substances, and (iii) the ability to influence the host immune system so that it controls other (competing) pathogens. B. fragilis, which accounts for only 0.5% of the human colonic flora, is the most commonly isolated anaerobic pathogen due, in part, to its potent virulence factors. Species of the genus Bacteroides have the most antibiotic resistance mechanisms and the highest resistance rates of all anaerobic pathogens. Clinically, Bacteroides species have exhibited increasing resistance to many antibiotics, including cefoxitin, clindamycin, metronidazole, carbapenems, and fluoroquinolones (e.g., gatifloxacin, levofloxacin, and moxifloxacin).

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Section: Infections In Adultsmentioning

confidence: 45%

Bacteroides: the Good, the Bad, and the Nitty-Gritty

2007

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“…Necrotizing fasciitis is one of the most severe soft tissue infections, having high mortality rates even in highly qualified centers 1 . All researchers are unanimous in asserting the importance of early diagnosis and treatment for improving the current survival rates [3][4][5] .…”

Section: Discussionmentioning

confidence: 99%

“…A high index of suspicion, early diag nosis, aggressive surgical exploration and debridement, antibiotics, and ICU support are key factors in successful management of these patients. In cases with an unconfirmed diagnosis, the diagnosis can be based on inspection of frozen-section biopsy specimens obtained through a small incision under local anesthesia 1,8 . For patients in early stages of fasciitis, debridement should be considered as soon as the margins of the necrotic lesion are clearly defined; in later stages, debridement should be performed after the patient is clinically stable 4 .…”

Section: Discussionmentioning

confidence: 99%

“…Necrotizing fasciitis is characterized by a severe infec tion involving the subcutaneous tissue and superficial fascia 1 . Despite advances in the field of critical care, mortality for this disease remains very high (15%-50%), making early diagnosis and suitable therapy crucial 1 .…”

Section: Introductionmentioning

confidence: 99%

“…Despite advances in the field of critical care, mortality for this disease remains very high (15%-50%), making early diagnosis and suitable therapy crucial 1 . This fulminant disease is characterized by an infection, usually polymicrobial, caused by necrotoxin-producing bacteria (beta-hemolytic group A estreptococcus, Staphylococcus aureus, and anaerobes).…”

Section: Introductionmentioning

confidence: 99%

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Fasceíte necrotizante após aplicação de injeção intramuscular

Alvarez¹,

Siqueira²,

Oliveira³

et al. 2012

Rev. Bras. Cir. Plást.

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We report the case of a 1-year-old boy who developed necrotizing fasciitis of the groin and thighs after intramuscular injection of metoclopramide. We discuss and highlight the key aspects of diagnosis and treatment of this disease, with an emphasis on the importance of early identification of factors that can contribute significantly to improved survival.Keywords: Fasciitis. Debridement. Metoclopramide. RESUMOÉ relatado o caso de um paciente do sexo masculino, de 1 ano e 2 meses, apresentando quadro de fasceíte necrotizante comprometendo região inguinal e coxas após injeção intramuscular de metoclopramida. Neste artigo, são discutidos e apontados os aspectos fundamentais do diagnóstico e tratamento da doença, ressaltando a importância da identificação precoce dos fatores que possam contribuir significativamente para melhora da sobrevida.Descritores: Fasciite. Desbridamento. Metoclopramida.

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