Bacterial isolates in necrotizing fasciitis and their antimicrobial susceptibility in a tertiary hospital in Nigeria: A prospective descriptive study

Abstract

Background Necrotizing fasciitis (NF) is a deadly soft tissue infection characterized by fascia necrosis caused by different organisms. It requires prompt diagnosis, adequate debridement, and administration of proper empirical antibiotics pending the outcome of wound culture to reduce morbidity and mortality. Aims This study aimed to identify the pathogenic organism(s) in patients with NF and their susceptibility pattern to readily available antimicrobial drugs. Material A prospective descriptive study of all consenting patients with NF managed at the Plastic and Reconstructive division of the Usmanu Danfodiyo University Teaching Hospital Sokoto, Sokoto state, Northwestern Nigeria, Northwest Nigeria, from September 2018 to August 2019. Samples were collected for aerobic, anaerobic, and fungal cultures. Antibiotic susceptibility testing was carried out using the Kirby–Bauer disk diffusion method. Results Thirty-two patients consisting of 20 (62.5%) males were studied with a median age of 35 years. Polymicrobial infection was more common (75%) in the 96 samples cultured. Escherichia coli was the most common isolate in 20 (28.9%) of the 69 positive cultures, whereas Peptostreptococcus species was the most common anaerobe isolated. E. coli and Staphylococcus aureus, the two most common organisms in the study, showed high susceptibility to ciprofloxacin, 90% and 84.6%, respectively. All the anaerobes showed 100% susceptibility to meropenem. Conclusion Ciprofloxacin and meropenem should be considered in the empirical antimicrobial treatment of NF.

Keywords

• antimicrobial susceptibility
• bacterial isolate
• escherichia coli
• necrotizing fasciitis