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Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery
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: Necrotis...
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| Format: | Thesis |
| Language: | English |
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University of Cape Town
2020
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| _version_ | 1867613233513234432 |
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| access_status_str | Open Access |
| author | Mabogoane, Tumiso |
| author2 | Kloppers, Jacobus |
| author_browse | Kloppers, Jacobus Mabogoane, Tumiso |
| author_facet | Kloppers, Jacobus Mabogoane, Tumiso |
| author_sort | Mabogoane, Tumiso |
| collection | Thesis |
| description | 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. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/32451 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:52.713Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | University of Cape Town |
| publisherStr | University of Cape Town |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/32451 Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery Mabogoane, Tumiso Kloppers, Jacobus Rayamajhi Shreya Surgery 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. 2020-12-30T10:17:55Z 2020-12-30T10:17:55Z 2020 Master Thesis Masters MMed http://hdl.handle.net/11427/32451 eng application/pdf University of Cape Town Division of General Surgery Faculty of Health Sciences |
| spellingShingle | Surgery Mabogoane, Tumiso Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery |
| thesis_degree_str | Master's |
| title | Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery |
| title_full | Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery |
| title_fullStr | Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery |
| title_full_unstemmed | Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery |
| title_short | Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery |
| title_sort | describing the resistance patterns of necrotising fasciitis in acute care surgery |
| topic | Surgery |
| url | http://hdl.handle.net/11427/32451 |
| work_keys_str_mv | AT mabogoanetumiso describingtheresistancepatternsofnecrotisingfasciitisinacutecaresurgery |