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J Microbiol Immunol Infect. 2007 Aug;40(4):335-41.

Necrotizing fasciitis in a medical center in northern Taiwan: emergence of methicillin-resistant Staphylococcus aureus in the community.

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  • 1Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Neihu, Taipei, Taiwan.

Abstract

BACKGROUND AND PURPOSE:

Necrotizing fasciitis (NF) is a rapidly progressive life-threatening infection. It is located in the deep fascia, with secondary necrosis of the subcutaneous tissues requiring urgent surgical and medical therapy. Staphylococcus aureus is, historically, a very uncommon cause of NF, but we have recently noted an increasing number of these infections being caused by community-acquired methicillin-resistant S. aureus (CA-MRSA).

METHODS:

The medical records of 53 patients diagnosed with NF between January 2001 and December 2005 were reviewed. A standardized instrument was used to abstract information from the medical records of each patient.

RESULTS:

S. aureus monomicrobial infection accounted for 37.7% (20/53) of the causal organisms noted. Of the 20 strains of S. aureus, 8 were methicillin-sensitive S. aureus and 12 were MRSA. In the 12 patients with MRSA infection, 7 had CA-MRSA. All patients with NF caused by CA-MRSA had no serious coexisting conditions or risk factors. All CA-MRSA isolates were susceptible to ciprofloxacin, trimethoprim-sulfamethoxazole, and vancomycin in vitro. All were cured after surgical intervention and medical treatment.

CONCLUSIONS:

For patients with severe invasive NF caused by CA-MRSA, glycopeptides may be prescribed as an empirical treatment until susceptibility results. The prognosis of NF caused by CA-MRSA was good after adequate surgical and antimicrobial treatment.

PMID:
17712468
[PubMed - indexed for MEDLINE]
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