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-
1
McHenry CR, Piotrowski JJ, Petrinic D, Malangoni MA, 1995. Determinants of mortality for necrotizing soft-tissue infections. Ann Surg 221 :558–563.
-
2
Anaya DA, Dellinger EP, 2007. Necrotizing soft-tissue infection: diagnosis and management. Clin Infect Dis 44 :705–710.
-
3
DiNubile MJ, Lipsky BA, 2004. Complicated infections of skin and skin structures: when the infection is more than skin deep. J Antimicrob Chemother 53 (Suppl 2):ii37–ii50.
-
4
Chen JL, Fullerton KE, Flynn NM, 2001. Necrotizing fasciitis associated with injection drug use. Clin Infect Dis 33 :6–15.
-
5
Miller LG, Perdreau-Remington F, Rieg G, Mehdi S, Perlroth J, Bayer AS, Tang AW, Phung TO, Spellberg B, 2005. Necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus in Los Angeles. N Engl J Med 352 :1445–1453.
-
6
Howard RJ, Pessa ME, Brennaman BH, Ramphal R, 1985. Necrotizing soft tissue infections caused by marine vibrios. Surgery 98 :126–130.
-
7
Majeski J, Majeski E, 1997. Necrotizing fasciitis: improved survival with early recognition by tissue biopsy and aggressive surgical treatment. South Med J 90 :1065–1068.
-
8
Wong CH, Chang HC, Pasupathy S, Khin LW, Tan JL, Low CO, 2003. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am 85 :1454–1460.
-
9
Elliott D, Kufera JA, Myers RA, 2000. The microbiology of necrotizing soft tissue infections. Am J Surg 179 :361–366.
-
10
Lille ST, Sato TT, Engrav LH, Foy H, Jurkovich GJ, 1996. Necrotizing soft tissue infections: obstacles in diagnosis. J Am Coll Surg 182 :7–11.
-
11
Childers BJ, Potyondy LD, Nachreiner R, Rogers FR, Childers ER, Oberg KC, Hendricks DL, Hardesty RA, 2002. Necrotizing fasciitis: a fourteen-year retrospective study of 163 consecutive patients. Am Surg 68 :109–116.
-
12
Hasham S, Matteucci P, Stanley PR, Hart NB, 2005. Necrotising fasciitis. BMJ 330 :830–833.
-
13
Eke N, 2000. Fournier’s gangrene: a review of 1726 cases. Br J Surg 87 :718–728.
-
14
Maalej S, Mahjoubi A, Elazri C, Dukan S, 2003. Simultaneous effects of environmental factors on motile Aeromonas dynamics in an urban effluent and in the natural seawater. Water Res 37 :2865–2874.
-
15
Kim JH, Park JH, Lee TS, Lee HJ, Kim SJ, 2001. Distribution of pathogenic Vibrios and environmental factors affecting their occurrence in the seawater of live fish tank. J Fd Hyg Safety 16 :241–246.
-
16
Patz JA, 2002. A human disease indicator for the effects of recent global climate change. Proc Natl Acad Sci USA 99 :12506–12508.
-
17
Hiransuthikul N, Tantisiriwat W, Lertutsahakul K, Vibhagool A, Boonma P, 2005. Skin and soft-tissue infections among tsunami survivors in southern Thailand. Clin Infect Dis 41 :e93–e96.
-
18
Center for Disease Control and Prevention, 2005. Vibrio illnesses after hurricane Katrina–multiple states, August–September 2005. MMWR Morb Mortal Wkly Rep 54 :928–931.
-
19
Tang WM, Ho PL, Fung KK, Yuen KY, Leong JC, 2001. Necrotising fasciitis of a limb. J Bone Joint Surg Br 83 :709–714.
-
20
Aitken DR, Mackett MC, Smith LL, 1982. The changing pattern of hemolytic streptococcal gangrene. Arch Surg 117 :561–567.
-
21
Bilton BD, Zibari GB, McMillan RW, Aultman DF, Dunn G, McDonald JC, 1998. Aggressive surgical management of necrotizing fasciitis serves to decrease mortality: a retrospective study. Am Surg 64 :397–400.
-
22
Kuo YL, Shieh SJ, Chiu HY, Lee JW, 2007. Necrotizing fasciitis caused by Vibrio vulnificus: epidemiology, clinical findings, treatment and prevention. Eur J Clin Microbiol Infect Dis 26 :785–792.
-
23
Voros D, Pissiotis C, Georgantas D, Katsaragakis S, Antoniou S, Papadimitriou J, 1993. Role of early and extensive surgery in the treatment of severe necrotizing soft tissue infection. Br J Surg 80 :1190–1191.
-
24
Tsai YH, Hsu RW, Huang TJ, Hsu WH, Huang KC, Li YY, Peng KT, 2007. Necrotizing soft-tissue infections and sepsis caused by Vibrio vulnificus compared with those caused by Aeromonas species. J Bone Joint Surg Am 89 :631–636.
-
25
Tsai YH, Hsu RW, Huang KC, Chen CH, Cheng CC, Peng KT, Huang TJ, 2004. Systemic Vibrio Infection presenting as necrotizing fasciitis and sepsis. A series of thirteen cases. J Bone Joint Surg Am 86 :2497–2502.
-
26
Elliott DC, Kufera JA, Myers RA, 1996. Necrotizing soft tissue infections. Risk factors for mortality and strategies for management. Ann Surg 224 :672–683.
-
27
Anaya DA, McMahon K, Nathens AB, Sullivan SR, Foy H, Bulger E, 2005. Predictors of mortality and limb loss in necrotizing soft tissue infections. Arch Surg 140 :151–157.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 222 | 156 | 9 |
| Full Text Views | 366 | 5 | 0 |
| PDF Downloads | 142 | 6 | 0 |
Marine Bacteria as a Leading Cause of Necrotizing Fasciitis in Coastal Areas of South Korea
Kyung-Hwa Park
Kyung-Hwa Park
Department of Internal Medicine, Department of Laboratory Medicine, and Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, South Korea
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Sook-In Jung
Sook-In Jung
Department of Internal Medicine, Department of Laboratory Medicine, and Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, South Korea
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Young-Sun Jung
Young-Sun Jung
Department of Internal Medicine, Department of Laboratory Medicine, and Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, South Korea
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Jong-Hee Shin
Jong-Hee Shin
Department of Internal Medicine, Department of Laboratory Medicine, and Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, South Korea
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Jae-Ha Hwang
Jae-Ha Hwang
Department of Internal Medicine, Department of Laboratory Medicine, and Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, South Korea
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Necrotizing fasciitis is a life-threatening soft-tissue infection. It is useful to know the etiology of this disease in each community and region because this information can facilitate early diagnosis and treatment. We reviewed medical records of 217 consecutive patients with necrotizing fasciitis in South Korea. Etiologic organisms were documented in 171 (78.8%) patients. Gram-negative marine bacteria were the most common organisms (68.4%). Seasonal variation in incidence occurred during warmer periods. Liver cirrhosis and alcoholism were common underlying illnesses. Gastrointestinal symptoms were more common in persons infected with gram-negative marine bacteria (56.4% versus 29.6%). Gram-negative bacteria were the predominant pathogens in multiple site involvement. Acute Physiology and Chronic Health Evaluation II scores, marine bacteria, and medical treatment without surgery affected mortality. When necrotic areas included less than three extremities, fasciotomy improved the survival rate. In coastal areas, gram-negative marine bacteria are the most common pathogens associated with necrotizing fasciitis. Fasciotomy can improve survival of patients with necrotic areas that involve less than three sites in necrotizing fasciitis.
Author Notes
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-
1
McHenry CR, Piotrowski JJ, Petrinic D, Malangoni MA, 1995. Determinants of mortality for necrotizing soft-tissue infections. Ann Surg 221 :558–563.
-
2
Anaya DA, Dellinger EP, 2007. Necrotizing soft-tissue infection: diagnosis and management. Clin Infect Dis 44 :705–710.
-
3
DiNubile MJ, Lipsky BA, 2004. Complicated infections of skin and skin structures: when the infection is more than skin deep. J Antimicrob Chemother 53 (Suppl 2):ii37–ii50.
-
4
Chen JL, Fullerton KE, Flynn NM, 2001. Necrotizing fasciitis associated with injection drug use. Clin Infect Dis 33 :6–15.
-
5
Miller LG, Perdreau-Remington F, Rieg G, Mehdi S, Perlroth J, Bayer AS, Tang AW, Phung TO, Spellberg B, 2005. Necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus in Los Angeles. N Engl J Med 352 :1445–1453.
-
6
Howard RJ, Pessa ME, Brennaman BH, Ramphal R, 1985. Necrotizing soft tissue infections caused by marine vibrios. Surgery 98 :126–130.
-
7
Majeski J, Majeski E, 1997. Necrotizing fasciitis: improved survival with early recognition by tissue biopsy and aggressive surgical treatment. South Med J 90 :1065–1068.
-
8
Wong CH, Chang HC, Pasupathy S, Khin LW, Tan JL, Low CO, 2003. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am 85 :1454–1460.
-
9
Elliott D, Kufera JA, Myers RA, 2000. The microbiology of necrotizing soft tissue infections. Am J Surg 179 :361–366.
-
10
Lille ST, Sato TT, Engrav LH, Foy H, Jurkovich GJ, 1996. Necrotizing soft tissue infections: obstacles in diagnosis. J Am Coll Surg 182 :7–11.
-
11
Childers BJ, Potyondy LD, Nachreiner R, Rogers FR, Childers ER, Oberg KC, Hendricks DL, Hardesty RA, 2002. Necrotizing fasciitis: a fourteen-year retrospective study of 163 consecutive patients. Am Surg 68 :109–116.
-
12
Hasham S, Matteucci P, Stanley PR, Hart NB, 2005. Necrotising fasciitis. BMJ 330 :830–833.
-
13
Eke N, 2000. Fournier’s gangrene: a review of 1726 cases. Br J Surg 87 :718–728.
-
14
Maalej S, Mahjoubi A, Elazri C, Dukan S, 2003. Simultaneous effects of environmental factors on motile Aeromonas dynamics in an urban effluent and in the natural seawater. Water Res 37 :2865–2874.
-
15
Kim JH, Park JH, Lee TS, Lee HJ, Kim SJ, 2001. Distribution of pathogenic Vibrios and environmental factors affecting their occurrence in the seawater of live fish tank. J Fd Hyg Safety 16 :241–246.
-
16
Patz JA, 2002. A human disease indicator for the effects of recent global climate change. Proc Natl Acad Sci USA 99 :12506–12508.
-
17
Hiransuthikul N, Tantisiriwat W, Lertutsahakul K, Vibhagool A, Boonma P, 2005. Skin and soft-tissue infections among tsunami survivors in southern Thailand. Clin Infect Dis 41 :e93–e96.
-
18
Center for Disease Control and Prevention, 2005. Vibrio illnesses after hurricane Katrina–multiple states, August–September 2005. MMWR Morb Mortal Wkly Rep 54 :928–931.
-
19
Tang WM, Ho PL, Fung KK, Yuen KY, Leong JC, 2001. Necrotising fasciitis of a limb. J Bone Joint Surg Br 83 :709–714.
-
20
Aitken DR, Mackett MC, Smith LL, 1982. The changing pattern of hemolytic streptococcal gangrene. Arch Surg 117 :561–567.
-
21
Bilton BD, Zibari GB, McMillan RW, Aultman DF, Dunn G, McDonald JC, 1998. Aggressive surgical management of necrotizing fasciitis serves to decrease mortality: a retrospective study. Am Surg 64 :397–400.
-
22
Kuo YL, Shieh SJ, Chiu HY, Lee JW, 2007. Necrotizing fasciitis caused by Vibrio vulnificus: epidemiology, clinical findings, treatment and prevention. Eur J Clin Microbiol Infect Dis 26 :785–792.
-
23
Voros D, Pissiotis C, Georgantas D, Katsaragakis S, Antoniou S, Papadimitriou J, 1993. Role of early and extensive surgery in the treatment of severe necrotizing soft tissue infection. Br J Surg 80 :1190–1191.
-
24
Tsai YH, Hsu RW, Huang TJ, Hsu WH, Huang KC, Li YY, Peng KT, 2007. Necrotizing soft-tissue infections and sepsis caused by Vibrio vulnificus compared with those caused by Aeromonas species. J Bone Joint Surg Am 89 :631–636.
-
25
Tsai YH, Hsu RW, Huang KC, Chen CH, Cheng CC, Peng KT, Huang TJ, 2004. Systemic Vibrio Infection presenting as necrotizing fasciitis and sepsis. A series of thirteen cases. J Bone Joint Surg Am 86 :2497–2502.
-
26
Elliott DC, Kufera JA, Myers RA, 1996. Necrotizing soft tissue infections. Risk factors for mortality and strategies for management. Ann Surg 224 :672–683.
-
27
Anaya DA, McMahon K, Nathens AB, Sullivan SR, Foy H, Bulger E, 2005. Predictors of mortality and limb loss in necrotizing soft tissue infections. Arch Surg 140 :151–157.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 222 | 156 | 9 |
| Full Text Views | 366 | 5 | 0 |
| PDF Downloads | 142 | 6 | 0 |