Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery

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dc.contributor.advisorKloppers, Jacobus
dc.contributor.advisorRayamajhi Shreya
dc.contributor.authorMabogoane, Tumiso
dc.date.accessioned2020-12-30T10:17:55Z
dc.date.available2020-12-30T10:17:55Z
dc.date.issued2020
dc.description.abstractObjective: This study aims to identify the microorganisms and antibiotic resistance patterns in necrotising fasciitis. Methods: This is a retrospective audit over two consecutive years (June 2015 - July 2017) of all patients who had surgery for necrotising fasciitis at an ACS unit. Results: Necrotising fasciitis accounted for 15% of all skin and soft tissue sepsis that required surgery. There were 10 male (52.6%) and nine female (47.4%) patients. The most common co-morbidity was diabetes mellitus in 10 (52.6%) patients, the compliance and control were monitored by glycosylated haemoglobin (HbA1C) in 50% of the diabetic group, with a mean of 8.98 (Range 5-12.9). Fifteen percent of cases (n=3) had a confirmed diagnosis of HIV, with a negative result in eight (42%). ICU was required in three patients two of whom were on inotropes and one patient required renal replacement therapy. Surgery was performed within 24 hours for 11 (57%) patients. The most common anatomical site for debridement was perineum in nine patients (47%). Monomicrobial infection was the most common subtype of necrotising fasciitis with methicillin sensitive staphylococcus aureus in five (26%) as the predominant microbe. Gram-negative organism Escherichia-coli was the second most common monomicrobial infection. All Gram-positive organisms were sensitive to cloxacillin and coamoxiclavulanic acid. Two gram negatives(15%) of the 13 organisms cultured were resistant to co-amoxiclavulanic acid. The 30 day mortality was 15%. Conclusion- Necrotising fasciitis is a rare but lethal infection. In our limited series, monomicrobial infection is the most common subtype. 15% of the community acquired organisms were resistant to the empiric antibiotic of choice co-amoxiclavulanic acid.
dc.identifier.apacitationMabogoane, T. (2020). <i>Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery</i>. (Master Thesis). University of Cape Town. Retrieved from http://hdl.handle.net/11427/32451en_ZA
dc.identifier.chicagocitationMabogoane, Tumiso. <i>"Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery."</i> Master Thesis., University of Cape Town, 2020. http://hdl.handle.net/11427/32451en_ZA
dc.identifier.citationMabogoane, T. 2020. Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery. Master Thesis. University of Cape Town. http://hdl.handle.net/11427/32451en_ZA
dc.identifier.ris TY - Master Thesis AU - Mabogoane, Tumiso AB - Objective: This study aims to identify the microorganisms and antibiotic resistance patterns in necrotising fasciitis. Methods: This is a retrospective audit over two consecutive years (June 2015 - July 2017) of all patients who had surgery for necrotising fasciitis at an ACS unit. Results: Necrotising fasciitis accounted for 15% of all skin and soft tissue sepsis that required surgery. There were 10 male (52.6%) and nine female (47.4%) patients. The most common co-morbidity was diabetes mellitus in 10 (52.6%) patients, the compliance and control were monitored by glycosylated haemoglobin (HbA1C) in 50% of the diabetic group, with a mean of 8.98 (Range 5-12.9). Fifteen percent of cases (n=3) had a confirmed diagnosis of HIV, with a negative result in eight (42%). ICU was required in three patients two of whom were on inotropes and one patient required renal replacement therapy. Surgery was performed within 24 hours for 11 (57%) patients. The most common anatomical site for debridement was perineum in nine patients (47%). Monomicrobial infection was the most common subtype of necrotising fasciitis with methicillin sensitive staphylococcus aureus in five (26%) as the predominant microbe. Gram-negative organism Escherichia-coli was the second most common monomicrobial infection. All Gram-positive organisms were sensitive to cloxacillin and coamoxiclavulanic acid. Two gram negatives(15%) of the 13 organisms cultured were resistant to co-amoxiclavulanic acid. The 30 day mortality was 15%. Conclusion- Necrotising fasciitis is a rare but lethal infection. In our limited series, monomicrobial infection is the most common subtype. 15% of the community acquired organisms were resistant to the empiric antibiotic of choice co-amoxiclavulanic acid. DA - 2020 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PY - 2020 T1 - Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery TI - Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery UR - http://hdl.handle.net/11427/32451 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/32451
dc.identifier.vancouvercitationMabogoane T. Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery. [Master Thesis]. University of Cape Town, 2020 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/32451en_ZA
dc.language.isoeng
dc.publisherUniversity of Cape Town
dc.publisher.departmentDivision of General Surgery
dc.publisher.facultyFaculty of Health Sciences
dc.subject.otherSurgery
dc.titleDescribing the resistance patterns of necrotising fasciitis in Acute Care Surgery
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMed
uct.type.publicationResearch
uct.type.resourceMaster Thesis
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