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The Korean Journal of Medicine 2006;70(6): 681-687.
원저 : 국내 세 개 대학 병원에서 괴사성 근막염의 특징
이민우, Tae Hyong Kim, Eun Joo Choo, Jee Heon Kang, Do Whan Kim, Dong Kyun Kim, Sang Wook Park, Ji Hoon An, Hyung Geun Yoon, Sung June Eo, Gun Wha Lee, Young Ha Lee, Joon Young Lee, Kang Il Cheon
Original Articles : Characteristics of necrotizing fasciitis in three university hospitals in Korea
Min Woo Lee, Tae Hyong Kim, Eun Joo Choo, Jee Heon Kang, Do Whan Kim, Dong Kyun Kim, Sang Wook Park, Ji Hoon An, Hyung Geun Yoon, Sung June Eo, Gun Wha Lee, Young Ha Lee, Joon Young Lee, Kang Il Cheon
한림의대 한강성심병원 내과
ABSTRACT
Background : Necrotizing fasciitis is a life threatening severe soft tissue infection primarily involving the fascia and the subcutaneous tissue with thrombosis of the cutaneous microcirculation. The purpose of the study was to analyze the microbiological and clinical characteristics of necrotizing fasciitis in Korea and to suggest adequate antibiotic therapy. Methods : We retrospectively reviewed medical records of three Soonchunhyang University Hospitals in Seoul, Bucheon and Cheonan. Patients admitted for skin graft or secondary treatment were excluded. Blood cultures were obtained at the time of admission and pus cultures were obtained at the time of first operative debridement. Results : Twenty two patients (16 males, 6 females, 16~82 years old, median age: 59 years old) were enrolled for this study. Fourteen pateints underwent surgical treatment and 2 of them died of necrotizing fasciitis. Gram positive organisms were isolated in 13 cases and gram negative organisms were isolated in 11 cases. Third generation cephalosporin resistant gram negative organisms were isolated in 3 cases. Conclusions : This study suggest that characteristics of necrotizing fascitis in Korea were; high proportion of aged person, predominance of type 2 necrotizing fascitis and increasing tendency of third generation cephalosporin resistant gram negative bacterial infections. Consequently, initial choice of empirical antibiotics for necrotizing fasciitis should consider 3rd generation cephalosporin resistant gram negative organisms. Prompt surgical debridement and adequate antimicrobial therapy are mandatory for improved survival.(Korean J Med 70:681-687, 2006) Key Words : Necrotizing fasciitis, Cephalosporin resistance
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