Describing the resistance patterns of necrotising fasciitis in acute care surgery
| dc.contributor.advisor | Rayamajhi Shreya | |
| dc.contributor.advisor | Kloppers, Jacobus | |
| dc.contributor.author | Mabogoane, Tumiso B M | |
| dc.date.accessioned | 2022-02-22T06:38:16Z | |
| dc.date.available | 2022-02-22T06:38:16Z | |
| dc.date.issued | 2021 | |
| dc.date.updated | 2022-02-22T06:37:38Z | |
| dc.description.abstract | 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 withmethicillin 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 co- amoxiclavulanic acid. Two gram negatives(15%) of the 13 organisms cultured were resistant to coamoxiclavulanic 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. (word count= 261). | |
| dc.identifier.apacitation | Mabogoane, T. B. M. (2021). <i>Describing the resistance patterns of necrotising fasciitis in acute care surgery</i>. (). ,Faculty of Health Sciences ,Division of General Surgery. Retrieved from http://hdl.handle.net/11427/35812 | en_ZA |
| dc.identifier.chicagocitation | Mabogoane, Tumiso B M. <i>"Describing the resistance patterns of necrotising fasciitis in acute care surgery."</i> ., ,Faculty of Health Sciences ,Division of General Surgery, 2021. http://hdl.handle.net/11427/35812 | en_ZA |
| dc.identifier.citation | Mabogoane, T.B.M. 2021. Describing the resistance patterns of necrotising fasciitis in acute care surgery. . ,Faculty of Health Sciences ,Division of General Surgery. http://hdl.handle.net/11427/35812 | en_ZA |
| dc.identifier.ris | TY - Master Thesis AU - Mabogoane, Tumiso B M 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 withmethicillin 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 co- amoxiclavulanic acid. Two gram negatives(15%) of the 13 organisms cultured were resistant to coamoxiclavulanic 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. (word count= 261). DA - 2021 DB - OpenUCT DP - University of Cape Town KW - acute care surgery LK - https://open.uct.ac.za PY - 2021 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/11427/35812 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/35812 | |
| dc.identifier.vancouvercitation | Mabogoane TBM. Describing the resistance patterns of necrotising fasciitis in acute care surgery. []. ,Faculty of Health Sciences ,Division of General Surgery, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/35812 | en_ZA |
| dc.language.rfc3066 | eng | |
| dc.publisher.department | Division of General Surgery | |
| dc.publisher.faculty | Faculty of Health Sciences | |
| dc.subject | acute care surgery | |
| dc.title | Describing the resistance patterns of necrotising fasciitis in acute care surgery | |
| dc.type | Master Thesis | |
| dc.type.qualificationlevel | Masters | |
| dc.type.qualificationlevel | MMed |