Microorganisms and Antibiogram Patterns in Fournier's Gangrene: Contemporary Experience from a Single Tertiary Care Center.J Urol. 2020 Jun 30 [Online ahead of print]JU
To evaluate the prevalent microorganisms, antibiotic sensitivity patterns, and associated outcomes in patients with Fournier's Gangrene (FG).
MATERIALS AND METHODS
A retrospective chart review of patients with FG was conducted between October 2011 and April 2018 at our institution. Univariate analysis was performed using independent t-test or Kruskal-Wallis H test for continuous variables and exact test for categorical variables.
Of the 143 patients included in this study, wound culture was available in 131 (92%) patients with a median number of 3 microorganisms per wound. The most commonly grown pathogens were Staphylococcus species (n= 66; 46%), Streptococcus species (n=53; 37%), Bacteroides species (n=34; 24%), Candida species (n=31, 22%), Escherichia coli (n=28; 20%), and Prevotella species (n=26, 18%). Most bacteria were sensitive to ampicillin-sulbactam, ceftriaxone, piperacillin-tazobactam, amikacin, and cefepime; and resistant to ampicillin, trimethoprim-sulfamethoxazole, levofloxacin, and clindamycin. Enterococcus faecalis and Streptococcus anginosus were resistant to vancomycin. The overall FG mortality rate was 14 (10%) patients. No association was noted between the type of infection and Fournier's gangrene severity index, length of hospital stay, or mortality.
At our institution, Candida is a prevalent pathogen in the wound culture of patients with FG. The resistance patterns for clindamycin and vancomycin are concerning. Addition of an antifungal agent to the empiric treatment should be considered based on clinical presentation.