Carrillo-Córdova LD, Aguilar-Aizcorbe S, Hernández-Farías MA, Acevedo-García C, Soria-Fernández G, Garduño-Arteaga ML

Language: Spanish
References: 29
Page: 327-331
PDF size: 170.10 Kb.

ABSTRACT

Background: Fournier gangrene (FG) is a necrotizing fasciitis that endangers the patient’s life. The objective of this study was to determine the etiology and impact of the agent isolated on wound and urine culture. Method: We performed a retrospective analysis within a cohort of 66 patients with FG of urogenital origin. The measured qualitative values were expressed as frequency and Percentage and compared with the chi square test and Fisher’s test. The difference was considered statistically significant at p ‹ 0.05. Results: Patients who died had more frequent cultures of urine and wound positive for extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli: urine, survivors 14.5% vs. deaths 44.4%; wound, 20.8% vs. 66.6% (p ‹ 0.001). Conclusions: During the integral evaluation of the patient with FG it is essential to perform the urine and surgical wound cultures in order to initiate the antibiotic management directed at an early stage. Patients with GF who die present a greater number of cultures positive for E. coli ESBL.

REFERENCES

1. Corcoran AT, Smaldone MC, Gibbons EP, Walsh TJ, Davies BJ. Validation of the Fournier’s gangrene severity index in a large contemporary series. J Urol. 2008;180):944–8.

2. Ozturk E, Ozguc H, Yilmazlar T. The use of vacuum assisted closure therapy in the management of Fournier’s gangrene. Am J Surg. 2009;197 660-5.

3. Czymek R, Schmidt A, Eckmann C, Bouchard R, Wulff B, Laubert T, et al. Fournier’s gangrene: vacuum-assisted closure versus conventional dressings. Am J Surg. 2009;197:168-76.

4. Morua AG, López JA, García JD, Montelongo RM, Guerra LS. Fournier’s gangrene: our experience in 5 years, bibliographic review and assessment of the Fournier’s gangrene severity index. Arch Esp Urol. 2009;62:532-40.

5. Sroczyński M, Sebastian M, Rudnicki J, Sebastian A, Agrawal AK. A complex approach to the treatment of Fournier’s gangrene. Adv Clin Exp Med. 2013;22:131-5.

6. Sorensen MD, Krieger JN. Fournier’s gangrene: epidemiology and outcomes in the general US population. Urol Int. 2016;97:249-59.

7. Hagedorn JC, Wessells H. A contemporary update on Fournier’s gangrene. Nat Rev Urol. 2017;14:205-14.

8. Tang LM, Su YJ, Lai YC. The evaluation of microbiology and prognosis of Fournier’s gangrene in past five years. Springerplus. 2015;4:14.

9. Horsanali MO, Eser U, Horsanali BO, Altas O, Eren H. WITHDRAWN: comparison of vacuum-assisted closure therapy and debridement with primer surgical closure for Fournier’s gangrene treatment: 10 years’ experience of a single centre. Int Braz J Urol. 2017;43.

10. Morais H, Neves J, Maciel Ribeiro H, Ferreira M, Guimaraes N, Azenha N, et al. Case series of Fournier’s gangrene: affected body surface area - the underestimated prognostic factor. Ann Med Surg (Lond). 2017;16:19-22.

11. Lin TY, Ou CH, Tzai TS, Tong YC, Chang CC, Cheng HL, et al. Validation and simplification of Fournier’s gangrene severity index. Int J Urol. 2014;21:696- 701.

12. Altarac S, Katusin D, Crnica S, Papes D, Rajkovic Z, Arslani F. Fournier’s gangrene: etiology and outcome analysis of 41 patients. Urol Int. 2012;88:289- 93.

13. Ulug M, Gedik E, Girgin S, Celen MK, Ataz C. The evaluation of microbiology and Fournier’s gangrene severity index in 27 patients. Int J Infect Dis. 2009;13:e424-30.

14. Kabay S, Yucel M, Yaylak F, Algin MC, Hacioglu A, Kabay B, et al. The clinical features of Fournier’s gangrene and the predictivity of the Fournier’s Gangrene Severity Index on the outcomes. Int Urol Nephrol. 2008;40:997-1004.

15. Erol B, Tuncel A, Hanci V, Tokgoz H, Yildiz A, Akduman B, et al. Fournier’s gangrene: overview of prognostic factors and definition of new prognostic parameter. Urology. 2010;75:1193-8.

16. Yilmazlar T, Gulcu B, Isik O, Ozturk E. Microbiological aspects of Fournier’s gangrene. Int J Surgery (Lond). 2017;40:135-8.

17. Meleney FL. Hemolytic streptococcus gangrene. Arch Surg. 1924;9: 317-364.

18. Ulug M, Gedik E, Girgin S, Celen MK, Ayaz C, et al. The evaluation of microbiology and Fournier’s gangrene severity index in 27 patients. Int J Infect Dis. 2009;13:e424-30.

19. Singh A, Ahmed K, Aydin A, Khan MS, Dasgupta P. Fournier’s gangrene. A clinical review. Arch Ital Urol. 2016;88:157-64.

20. Oguz A, Gumus M, Turkoglu A, Bozdag Z, Ulger BV, Agacayak E, et al. Fournier’s gangrene: a summary of 10 years of clinical experience. Int Surg. 2015;100:934-41.

21. Eke N, Raphael JE. Fournier’s gangrene. En: Vitin A, editor. Gangrene – current concepts and management options. InTech. 2011. p. 37-48. Disponible en: http://cdn intechopen.com/pdfs/18914/InTech-Fournier_s_ gangrene pdf.

22. European Association of Urology, National Guideline Clearinghouse (NGC). Fournier’s gangrene. En: Guidelines on urological infections. Disponible en: http://www guideline.gov/content aspx?id=34103.

23. Paty R, Smith AD. Gangrene and Fournier’s gangrene. Urol Clin North Am. 1992;19:149-62.

24. Palmer LS, Winter HI, Tolia BM, Reid RE, Laor E. The limited impact of involved surface area and surgical debridement on survival in Fournier’s gangrene. Br J Urol. 1995;76:208-12.

25. Ulug M, Gedik E, Girgin S, Celen M, Ayaz C. The evaluation of microbiology and Fournier’s gangrene severity index in 27 patients. Int J Infect Dis. 2009;13:e424–30.

26. Ayan F, Sunamak O, Paksoy SM, Polat SS, As A, Sakoglu N, et al. Fournier’s gangrene: a retrospective clinical study on forty-one patients. ANZ J Surg. 2005;75:1055-8.

27. Burton MJ, Shah P, Swiatlo E. Community-acquired methicillin-resistant Staphylococcus aureus as a cause of Fournier’s gangrene. Am J Med Sci. 2008;335:327-8.

28. Champion SE. A case of Fournier’s gangrene: signs and symptoms. Urol Nurs. 2007;27:296-9.

29. Ersay A, Yilmaz G, Akgun Y, Celik Y. Factors affecting mortality of Fournier’s gangrene: review of 70 patients. ANZ J Surg. 2007;77: 43-48.