Necrotizing Fasciitis Pathogen Can Predict Urgency

Vibrio vulnificus causes more rapidly progressing, fulminant infection than Staphylococcus aureus

MONDAY, Feb. 28 (HealthDay News) -- Necrotizing fasciitis caused by Vibrio vulnificus progresses faster and is more clinically fulminant than infections caused by Staphylococcus aureus, according to a study published in the Feb. 2 issue of The Journal of Bone & Joint Surgery.

Yao-Hung Tsai, M.D., of Chang Gung Memorial Hospital in Taiwan, and colleagues investigated the characteristics and clinical outcomes of necrotizing infections caused by Vibrio vulnificus and Staphylococcus aureus. They reviewed 60 cases of necrotizing fasciitis caused by Vibrio vulnificus and 55 cases caused by Staphylococcus aureus. They compared the mortality, patient characteristics, clinical presentations, laboratory data, and hospital courses of the two groups.

The researchers found an overall mortality rate of 16.5 percent; 11 patients in the Vibrio vulnificus group and eight in the Staphylococcus aureus group died. Compared to Staphylococcus aureus, Vibrio vulnificus infection was associated with lower systolic blood pressure, a greater likelihood of high body temperature, and a shorter interval between contact and admission. The patients with Vibrio vulnificus also had significantly lower total white blood cell counts, higher banded white blood cell counts, and lower platelet counts. Patients with methicillin-resistant Staphylococcus aureus were significantly more likely to be hypotensive than those with methicillin-sensitive Staphylococcus aureus. Hepatic dysfunction was associated with Vibrio vulnificus infection, while patients with diabetes mellitus were more likely to be infected with Staphylococcus aureus.

"Necrotizing fasciitis caused by Vibrio vulnificus and Staphylococcus aureus is a surgical emergency. Vibrio vulnificus infection progresses more rapidly and the clinical characteristics are more fulminant than either methicillin-resistant Staphylococcus aureus or methicillin-sensitive Staphylococcus aureus infection," the authors write.

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