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Volume 2020, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Necrotizing fasciitis (NF) is a rare but aggressive infection that affects the superficial fascia and progressively destroys the tissue between the skin and underlying muscles. It is a surgical emergency with significant morbidity and mortality. This study aimed to explore the temporal and seasonal trends in NF infection in Qatar. A total of 327 patients diagnosed with NF, aged ≥ 18 years, and admitted to the Hamad General Hospital, Qatar, in 2002–2013 were retrospectively reviewed. The hospitalization and mortality rates in the general population in Qatar and the case fatality rate (CFR) were calculated for each year. The patients were grouped into summer, autumn, winter, and spring admissions based on their admission dates. Seasonality was studied by comparing the characteristics, bacteriological status, and outcomes of the patients admitted in different seasons. The hospitalization rate of NF in Qatar was 2.9 per 100,000 population; in the study duration, this rate decreased from 2.8 to 1.6 per 100,000 population in 2002 and 2013, respectively. The mortality rate among NF cases increased from 1.9 to 3.6 per million population, and the CFR increased from 6.7 to 23 per 100 admissions in the same duration. No temporal trends in the hospitalization and mortality rates or CFR were evident in the study duration. Polybacterial infections were higher in autumn than in other seasons. Monobacterial Gram-positive infections were higher in spring than in other seasons, and monobacterial Gram-negative infections were higher in summer than in other seasons ( = 0.02). However, seasonality was not evident after further analysis in terms of species, severity, complications, length of hospital stays, and CFR in patients with NF. No clear trend or seasonality was observed in terms of outcomes; however, seasonality in NF-causing bacteria was evident, as polybacterial infections were significantly higher in autumn than in other seasons, whereas monobacterial infections were more frequent in spring and summer than in other seasons. However, the severity of infections, length of hospital stay, and mortality did not significantly vary. Further microbiological studies are needed to obtain confirmatory data regarding the temporal and seasonal trends of NF.

© 2020 Mekkodathil, El-Menyar, Mudali, Al-Sulaiti, Shaikh, Al-Thani, licensee HBKU Press.
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2020-12-23
2024-11-20
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References

  1. Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014; 59:e10–52 .
  2. Mulla ZD, Gibbs SG, Aronoff DM. Correlates of length of stay, cost of care, and mortality among patients hospitalized for necrotizing fasciitis. Epidemiol Infect. 2007;135:868–76 .
  3. Arifi HM, Duci SB, Zatriqi VK, Ahmeti HR, Ismajli VH, Gashi MM, et al. A retrospective study of 22 patients with necrotising fasciitis treated at the University Clinical Center of Kosovo (2005–2010). Int Wound J. 2013;10:461–5 .
  4. Proud D, Bruscino Raiola F, Holden D, Paul E, Capstick R, Khoo A. Are we getting necrotizing soft tissue infections right? A 10-year review. ANZ J Surg. 2014;84:468–72 .
  5. Wang JM, Lim HK. Necrotizing fasciitis: eight-year experience and literature review. Braz J Infect Dis. 2014;18:137–43 .
  6. Glass GE, Sheil F, Ruston JC, Butler PE. Necrotising soft tissue infection in a UK metropolitan population. Ann R Coll Surg Engl, 2015; 97:46–51 .
  7. Khamnuan P, Chongruksut W, Jearwattanakanok K, Patumanond J, Tantraworasin A. Necrotizing fasciitis: epidemiology and clinical predictors for amputation. Int J Gen Med. 2015;8:195–202 .
  8. Khamnuan P, Chongruksut W, Jearwattanakanok K, Patumanond J, Yodluangfun S,Tantraworasin A. Necrotizing fasciitis: risk factors of mortality. Risk Manag Healthc Policy. 2015;8:1–7 .
  9. Misiakos EP, Bagias G, Patapis P, Sotiropoulos D, Kanavidis P, Machairas A. Current concepts in the management of necrotizing fasciitis. Front Surg. 2014;1:36 .
  10. Yeh DD, Velmahos G. Necrotizing Soft Tissue Infections. In: Yelon JA, Luchette FA, editors. Geriatric Trauma and Critical Care, New York: Springer; 2014, p. 161–73 .
  11. Krieg A, Dizdar L, Verde PE, Knoefel WT. Predictors of mortality for necrotizing soft-tissue infections: a retrospective analysis of 64 cases. Langenbecks Arch Surg. 2014;399:333–41 .
  12. Nordqvist G, Walldén A, Brorson H, Tham J. Ten years of treating necrotizing fasciitis. Infect Dis (Lond). 2015;47:319–25 .
  13. Psoinos CM, Flahive JM, Shaw JJ, Li Y, Ng SC, Tseng JF, et al. Contemporary trends in necrotizing soft-tissue infections in the United States. Surgery. 2013;153:819–27 .
  14. Mishra SP, Singh S, Gupta SK. Necrotizing soft tissue infections: Surgeon's prospective. Int J Inflam. 2013;2013:609628 .
  15. Frazee BW, Fee C, Lynn J, Wang R, Bostrom A, Hargis C, et al. Community-acquired necrotizing soft tissue infections: a review of 122 cases presenting to a single emergency department over 12 years. J Emerg Med. 2008;34:139–46 .
  16. Gkrania-Klotsas E, Chew RC, Vrotsou K. Seasonal variation of group a streptococcus (GAS) related necrotising fasciitis cases in a UK teaching hospital. TOIDJ. 2008;2:1–7 .
  17. Fadel ZT, Burke E, Joukhadar N, Samargandi OA, Bezuhly M. Effects of seasonal changes in temperature and humidity on incidence of necrotizing soft tissue infections in Halifax, Canada, 2001–2015. Saudi Med J. 2019;40:469–74 .
  18. Shaikh N, El-Menyar A, Mudali IN, Tabeb A, Al-Thani H. Clinical presentations and outcomes of necrotizing fasciitis in males and females over a 13-year period. Ann Med Surg (Lond). 2015;4:355–60 .
  19. Jabbour G, El-Menyar A, Peralta R, Shaikh N, Abdelrahman H, Mudali IN, et al. Pattern and predictors of mortality in necrotizing fasciitis patients in a single tertiary hospital. World J Emerg Surg. 2016;11:40 .
  20. El-Menyar A, Asim M, Mudali IN, Mekkodathil A, Latifi R, Al-Thani H. The laboratory risk indicator for necrotizing fasciitis (LRINEC) scoring: the diagnostic and potential prognostic role. Scand J Trauma Resusc Emerg Med. 2017;25:28 .
  21. Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996;22:707–10 .
  22. Wong CH, Khin LW, Heng KS, Tan KC, Low CO. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med. 2004;32:1535–41 .
  23. Ministry of Development Planning and Statistics, Statistics [Internet], Doha, Qatar, 2014. Available from: https://www.mdps.gov.qa/en/Pages/default.aspx .
  24. Qatar Meteorology Department, Climatological Normals [Internet], Doha, Qatar, 2014. Available from: http://qweather.gov.qa/ClimateNormals.aspx .
  25. Newcombe RG. Two-sided confidence intervals for the single proportion: Comparison of seven methods. Stat Med. 1998;17:857–72 .
  26. Wilson EB. Probable inference, the law of succession, and statistical inference. J Am Stat Assoc. 1927;22:209–212 .
  27. Oud L, Watkins P. Contemporary trends of the epidemiology, clinical characteristics, and resource utilization of necrotizing fasciitis in Texas: A population-based cohort study. Crit Care Res Pract 2015;2015:618067 .
  28. Das DK, Baker MG, Venugopal K. Increasing incidence of necrotizing fasciitis in New Zealand: a nationwide study over the period 1990 to 2006. J Infect. 2011;63:429–33 .
  29. Hakkarainen TW, Kopari NM, Pham TN, Evans HL. Necrotizing soft tissue infections: review and current concepts in treatment, systems of care, and outcomes. Curr Probl Surg. 2014;51:344–62 .
  30. Leekha S, Diekema DJ, Perencevich EN. Seasonality of staphylococcal infections. Clin Microbiol Infect. 2012;18:927–33 .
  31. Roje Z, Roje Z, Matić D, Librenjak D, Dokuzović S, Varvodić J. Necrotizing fasciitis: literature review of contemporary strategies for diagnosing and management with three case reports: torso, abdominal wall, upper and lower limbs. World J Emerg Surg. 2011;6:46 .
  32. Frei CR, Makos BR, Daniels KR, Oramasionwu CU. Emergence of community-acquired methicillin-resistantStaphylococcus aureus skin and soft tissue infections as a common cause of hospitalization in United States children. J Pediatr Surg. 2010;45:1967–74 .
  33. Hisata K, Kuwahara-Arai K, Yamanoto M, Ito T, Nakatomi Y, Cui L, et al. Dissemination of methicillin-resistant staphylococci among healthy Japanese children. J Clin Microbiol. 2005;43:3364–3372 .
/content/journals/10.5339/qmj.2020.37
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Temporal and seasonal trends of hospitalization and mortality associated with necrotizing fasciitis: A retrospective study of 12 years (2002–2013)
Qatar Medical Journal 2020, 37 (2021); https://doi.org/10.5339/qmj.2020.37
/content/journals/10.5339/qmj.2020.37
/content/journals/10.5339/qmj.2020.37
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  • Article Type: Research Article
Keyword(s): necrotizing fasciitis, Qatar, season and temporal trend

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