Necrotizing fasciitis in patients with liver cirrhosis: predominance of monomicrobial Gram-negative bacillary infections

被引：49

作者：

Lee, Ching-Chi ^{[2
]}

Chi, Chih-Hsien ^{[2
,5
]}

Lee, Nan-Yao ^{[4
,7
]}

Lee, Hsin-Chun ^{[4
,5
,7
]}

Chen, Chung-Lin ^{[3
,5
]}

Chen, Po-Lin ^{[4
,7
]}

Chang, Chia-Ming ^{[4
,7
]}

Wu, Chi-Jung ^{[4
,7
]}

Ko, Nai-Ying ^{[4
,6
]}

Tsai, Ming-Che ^{[2
,5
]}

Ko, Wen-Chien ^{[1
,4
,5
,7
]}

机构：

[1] Natl Cheng Kung Univ Hosp, Div Infect Dis, Dept Internal Med, Tainan 704, Taiwan

[2] Natl Cheng Kung Univ Hosp, Dept Emergency Med, Tainan 704, Taiwan

[3] Natl Cheng Kung Univ Hosp, Dept Surg, Tainan 704, Taiwan

[4] Natl Cheng Kung Univ Hosp, Ctr Infect Control, Tainan 704, Taiwan

[5] Natl Cheng Kung Univ, Coll Med, Dept Med, Tainan 704, Taiwan

[6] Natl Cheng Kung Univ, Coll Med, Dept Nursing, Tainan 704, Taiwan

[7] Natl Cheng Kung Univ Hosp, Dept Internal Med, Tainan 704, Taiwan

来源：

DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE | 2008年 / 62卷 / 02期

关键词：

necrotizing fasciitis; liver cirrhosis; Gram-negative bacilli; Vibrio; Aeromonas;

D O I：

10.1016/j.diagmicrobio.2008.05.016

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Necrotizing, fasciitis (NF), a rare but severe infection, usually occurs in individuals with underlying chronic illness, but its clinical presentation among cirrhotic patients is infrequently discussed. Forty-two cirrhotic patients with 47 episodes of NF between 1995 and 2006 were analyzed. Their mean age was 55.6 years. with male preponderance (34 patients, 81%). Lower extremities were mainly involved (70%). Of 42 episodes with identified pathogens, 41 (97%) were monomicrobial infections and were caused mainly by Gram-negative rods (GNBs) (32, 76%). including Vibrio (15 36%), Klebsiella (9, 21%), and Aeromonas spp. (6, 14%). As compared with NF caused by Gram-positive cocci (GPCs), NF caused by GNBs tended to have concurrent bacteremia (81% versus 50%, P = 0.09) and initially presented with septic shock (75% versus 30%, P = 0.02). However, the in-hospital mortality rate was similar for NF caused by GNBs and GPCs (34% versus 30%, P = 1.00). In inultivariate analyses, higher sepsis-related organ failure assessment scores (>8) and Child-Pugh class C at initial presentation were independently associated with poor prognoses. (C) 2008 Elsevier Inc. All rights reserved.

引用

页码：219 / 225

页数：7

共 27 条

[1]

Bosshardt TL, 1996, ARCH SURG-CHICAGO, V131, P846

[2]

Bosshardt TL, 1996, ARCH SURG-CHICAGO, V131, P852

[3] Necrotising fasciitis: clinical features in patients with liver cirrhosis [J].