Risk factors, microbiological findings and outcomes of necrotizing fasciitis in New Zealand: a retrospective chart review

<p>Abstract</p> <p>Background</p> <p>The incidence and mortality from necrotizing fasciitis (NF) are increasing in New Zealand (NZ). Triggered by a media report that traditional Samoan tattooing was causing NF, we conducted a chart review to investigate the role of this...

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Main Authors: Das Dilip Kumar, Baker Michael G, Venugopal Kamalesh
Format: Article
Language:English
Published: BMC 2012-12-01
Series:BMC Infectious Diseases
Subjects:
Online Access:http://www.biomedcentral.com/1471-2334/12/348
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spelling doaj-8b5e86cada2845018f56b78180024c6f2020-11-25T03:59:52ZengBMCBMC Infectious Diseases1471-23342012-12-0112134810.1186/1471-2334-12-348Risk factors, microbiological findings and outcomes of necrotizing fasciitis in New Zealand: a retrospective chart reviewDas Dilip KumarBaker Michael GVenugopal Kamalesh<p>Abstract</p> <p>Background</p> <p>The incidence and mortality from necrotizing fasciitis (NF) are increasing in New Zealand (NZ). Triggered by a media report that traditional Samoan tattooing was causing NF, we conducted a chart review to investigate the role of this and other predisposing and precipitating factors and to document NF microbiology, complications and interventions in NZ.</p> <p>Methods</p> <p>We conducted a retrospective review of 299 hospital charts of patients discharged with NF diagnosis codes in eight hospitals in NZ between 2000 and 2006. We documented and compared by ethnicity the prevalence of predisposing and precipitating conditions, bacteria isolated, complications and interventions used.</p> <p>Results</p> <p>Out of 299 charts, 247 fulfilled the case definition. NF was most common in elderly males. Diabetes was the most frequent co-morbid condition, followed by obesity. Nearly a quarter of patients were taking non-steroidal anti-inflammatory drugs (NSAID). Traditional Samoan tattooing was an uncommon cause. <it>Streptococcus pyogenes</it> and <it>Staphylococcus aureus</it> were the two commonly isolated bacteria. Methicillin-resistant <it>Staphylococcus aureus</it> was implicated in a relatively small number of cases<it>.</it> Shock, renal failure, coagulation abnormality and multi-organ dysfunction were common complications. More than 90% of patients underwent surgical debridement, 56% were admitted to an intensive care unit (ICU) and slightly less than half of all patients had blood product transfusion. One in six NF cases had amputations and 23.5% died.</p> <p>Conclusion</p> <p>This chart review found that the highest proportion of NF cases was elderly males with co-morbidities, particularly diabetes and obesity. Tattooing was an uncommon precipitating event. The role of NSAID needs further exploration. NF is a serious disease with severe complications, high case fatality and considerable use of health care resources.</p> http://www.biomedcentral.com/1471-2334/12/348Bacterial infectionEthnicityNecrotizing fasciitisNew ZealandTraditional Samoan tattooing
collection DOAJ
language English
format Article
sources DOAJ
author Das Dilip Kumar
Baker Michael G
Venugopal Kamalesh
spellingShingle Das Dilip Kumar
Baker Michael G
Venugopal Kamalesh
Risk factors, microbiological findings and outcomes of necrotizing fasciitis in New Zealand: a retrospective chart review
BMC Infectious Diseases
Bacterial infection
Ethnicity
Necrotizing fasciitis
New Zealand
Traditional Samoan tattooing
author_facet Das Dilip Kumar
Baker Michael G
Venugopal Kamalesh
author_sort Das Dilip Kumar
title Risk factors, microbiological findings and outcomes of necrotizing fasciitis in New Zealand: a retrospective chart review
title_short Risk factors, microbiological findings and outcomes of necrotizing fasciitis in New Zealand: a retrospective chart review
title_full Risk factors, microbiological findings and outcomes of necrotizing fasciitis in New Zealand: a retrospective chart review
title_fullStr Risk factors, microbiological findings and outcomes of necrotizing fasciitis in New Zealand: a retrospective chart review
title_full_unstemmed Risk factors, microbiological findings and outcomes of necrotizing fasciitis in New Zealand: a retrospective chart review
title_sort risk factors, microbiological findings and outcomes of necrotizing fasciitis in new zealand: a retrospective chart review
publisher BMC
series BMC Infectious Diseases
issn 1471-2334
publishDate 2012-12-01
description <p>Abstract</p> <p>Background</p> <p>The incidence and mortality from necrotizing fasciitis (NF) are increasing in New Zealand (NZ). Triggered by a media report that traditional Samoan tattooing was causing NF, we conducted a chart review to investigate the role of this and other predisposing and precipitating factors and to document NF microbiology, complications and interventions in NZ.</p> <p>Methods</p> <p>We conducted a retrospective review of 299 hospital charts of patients discharged with NF diagnosis codes in eight hospitals in NZ between 2000 and 2006. We documented and compared by ethnicity the prevalence of predisposing and precipitating conditions, bacteria isolated, complications and interventions used.</p> <p>Results</p> <p>Out of 299 charts, 247 fulfilled the case definition. NF was most common in elderly males. Diabetes was the most frequent co-morbid condition, followed by obesity. Nearly a quarter of patients were taking non-steroidal anti-inflammatory drugs (NSAID). Traditional Samoan tattooing was an uncommon cause. <it>Streptococcus pyogenes</it> and <it>Staphylococcus aureus</it> were the two commonly isolated bacteria. Methicillin-resistant <it>Staphylococcus aureus</it> was implicated in a relatively small number of cases<it>.</it> Shock, renal failure, coagulation abnormality and multi-organ dysfunction were common complications. More than 90% of patients underwent surgical debridement, 56% were admitted to an intensive care unit (ICU) and slightly less than half of all patients had blood product transfusion. One in six NF cases had amputations and 23.5% died.</p> <p>Conclusion</p> <p>This chart review found that the highest proportion of NF cases was elderly males with co-morbidities, particularly diabetes and obesity. Tattooing was an uncommon precipitating event. The role of NSAID needs further exploration. NF is a serious disease with severe complications, high case fatality and considerable use of health care resources.</p>
topic Bacterial infection
Ethnicity
Necrotizing fasciitis
New Zealand
Traditional Samoan tattooing
url http://www.biomedcentral.com/1471-2334/12/348
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