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01-06-2021 | Necrotizing Fasciitis | Original Paper

Necrotizing fasciitis, causative agents and management: a five-year retrospective study in two tertiary care hospitals in Central Malaysia

Authors: Sanjiv Rampal, Sandra Maniam, Poh Ying Lim, Rubenandran Ramachandran, Eng Kee Tan, Mohd Asyraf Hafizuddin Ab Halim, Zulfahrizzat Shamsudin, Sandeep Singh Sarawan Singh, Pravind Narayanan, Vasantha Kumari Neela

Published in: International Orthopaedics | Issue 6/2021

Abstract

Purpose

Necrotizing fasciitis (NF) is a rapidly progressive inflammatory infection of the fascia, with secondary necrosis of the subcutaneous tissues. The severity of the disease depends on the virulence of the organism and host immunity. There is a paucity of reports on the prevalence of NF causing pathogens and management.

Methods

Retrospective data of patients treated for NF were collected from two tertiary care hospitals in Central Malaysia between January 2014 and December 2018.

Results

A total of 469 NF patients were identified. More than half of the NF patients were males (n = 278; 59.28%). The highest number of cases was found among age groups between 30 and 79, with mean age of 56.17. The majority of the NF cases (n = 402; 85.72%) were monomicrobial. Streptococcus spp. (n = 89; 18.98%), Pseudomonas aeruginosa (n = 63; 13.44%) and Staphylococcus spp. (n = 61; 13.01%) were identified as the top three microorganisms isolated. Among the 469 NF cases, 173 (36.8%) were amputated or dead while 296 (63.1%) recovered. Proteus spp. (n = 19; 12.93%), Klebsiella pneumoniae (n = 18; 12.24%) and Escherichia coli (n = 14; 9.52%) were associated with all types of amputations. The most common antibiotic prescribed was unasyn (n = 284; 60.56%), followed by clindamycin (n = 56; 11.94%) and ceftazidime (n = 41; 8.74%). A total of 239 (61.8%) recovered while 148 (38.2%) were either amputated or dead when managed with the unasyn, clindamycin or ceftazidime.

Conclusion

This study represents the largest NF cases series in Malaysia highlighting the causative agents and management.

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Title: Necrotizing fasciitis, causative agents and management: a five-year retrospective study in two tertiary care hospitals in Central Malaysia
Authors: Sanjiv Rampal
Sandra Maniam
Poh Ying Lim
Rubenandran Ramachandran
Eng Kee Tan
Mohd Asyraf Hafizuddin Ab Halim
Zulfahrizzat Shamsudin
Sandeep Singh Sarawan Singh
Pravind Narayanan
Vasantha Kumari Neela
Publication date: 01-06-2021
Publisher: Springer Berlin Heidelberg
Keywords: Necrotizing Fasciitis
Streptococci
Antibiotic
Care
Clindamycin
Ceftazidime
Pseudomonas Aeruginosa
Published in: International Orthopaedics / Issue 6/2021
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-020-04905-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Necrotizing fasciitis, causative agents and management: a five-year retrospective study in two tertiary care hospitals in Central Malaysia

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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