Title: Bacteriological Profile of Necrotising Fasciitis in A Teritary Care Centre
Authors: Dr Mariette Jane Pious, Dr J. Lancy, Dr Manjusree. S
DOI: https://dx.doi.org/10.18535/jmscr/v5i1.73
Abstract
Necrotising fasciitis is a potentially fatal infection that is rapidly progressive involving widespread necrosis of superficial fascia and subcutaneous tissue. It is usually associated with diabetes mellitus, trauma, Cirrhosis liver, chronic kidney disease, etc. The present study was conducted in the Department of Microbiology, Govt. Medical College, Thiruvananthapuram for a period of 1 year from May 2014 to April 2015. The objective of the study was to isolate and identify the bacterial pathogens causing Necrotising fasciitis from clinically diagnosed cases and to determine the Antibiotic susceptibility pattern of the isolates. A total number of 235 samples collected from the lesions of patients with necrotizing fasciitis admitted in the surgery wards during this period. Culture was positive in 222 samples (94.5%). Out of the total isolates, 96.5% were monomicrobial and 3.5% were poly microbial. The predominant isolate in the study was pseudomonas aeruginosa (37.44%) other isolates are Staphylococcus aureus (19.1%), Klebsiella species (11.91%), E.coli (7.65%), Streptococcus pyogenes (4.25%), Enterococci & Proteus vulgaris (3.4% each), Proteus mirabilis & CONS (2.97% each), MRSA (1.7%) and Enterobacter species (0.42%). The antibiotic sensitivity pattern of pseudomonas aeruginosa showed 100% sensitivity to Amikacin, Ceforazone – Sulbactum and Piperacillin tazobactam. Staphylococcus aureus isolates were sensitive to Cloxacilin, Amikacin and Vancomycin (100%). All the strains were resistant to penicillin. After treatment with appropriate antibiotics according to the antibiotic sensitivity pattern and surgical intervention, 204 (86.8%) patients survived. Mortality rate was 13.2% which was significantly reduced when compared to other studies because of the early treatment with appropriate antibiotics.
Keywords: Necrotising fasciitis, antibiotic susceptibility testing.
