Cervical necrotizing fasciitis: 8-years' experience of microbiology.
Cervical necrotizing fasciitis (CNF) is a life-threatening complication of pharyngeal or dental infections. The aim of this paper was to investigate whether dental or pharyngeal source result from different pathogen(s) in CNF and whether antibiotics, given before admission, influence the antimicrobial resistance of pathogens. In 152 CNF patients, Streptococcus milleri group and Prevotella species were the predominant isolates, frequently copathogens, mostly in dental CNF samples. Penicillin and clindamycin resistance were observed in 39% and 37% of cases, respectively, independently of any previous antibiotic therapy. Thus, a combined aerobe-anaerobe infection may have a synergistic effect, which allows the infection to spread in cervical tissues.
Fihman
V
V
Service de Bactériologie-Virologie, Université Paris 7-Denis Diderot, Groupe Hospitalier Lariboisière-Fernand Widal, GHU Nord, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75475 Paris Cedex 10, Paris, France. vincent.fihman@lrb.aphp.fr
Raskine
L
L
Petitpas
F
F
Mateo
J
J
Kania
R
R
Gravisse
J
J
Resche-Rigon
M
M
Farhat
I
I
Berçot
B
B
Payen
D
D
Sanson-Le Pors
M J
MJ
Herman
P
P
Mebazaa
A
A
D016866:Bacteroidaceae Infections / Q000382:microbiology; D002981:Clindamycin / Q000494:pharmacology; D019115:Fasciitis, Necrotizing / Q000382:microbiology*; D005491:Focal Infection, Dental / Q000382:microbiology*; D006801:Humans; D010406:Penicillins / Q000494:pharmacology*; D010608:Pharyngeal Diseases / Q000382:microbiology*; D018720:Prevotella / Q000187:drug effects*; D034364:Streptococcus milleri Group / Q000187:drug effects*
D010406:Penicillins; D002981:Clindamycin