title: Necrotizing fasciitis:  a six-year experience.
abstract: Necrotizing fasciitis (NF) is a life-threatening infectious disease whose incidence has been on the rise. Commonly a consequence of group A beta-hemolytic Streptococcus infection, it results in high levels of morbidity and mortality. Diagnosis is difficult and treatment involves emergent surgical intervention and antibiotic therapy. The aim of this study is to examine the incidence of NF in Manitoba with the goal of observing whether there is a geographic variation in incidence and outcomes based on Regional Health Authorities (RHAs). This is a 6-year retrospective chart review of all NF patients who presented to the Health Sciences Center from 2004 to 2009. A total of 130 patients satisfied the inclusion criteria. The mean age was 47 ± 16 years. The most common comorbidities were diabetes (33.8%) and hypertension (33.1%). The overall mortality was 13.1% with advanced age being an independent risk factor (P < .05). Lower extremity was the most common location of infection (44.6%) and the most common causative organism was group A beta-hemolytic Streptococcus (63.9%). The type of infection (mono- vs. polymicrobial) was not found to affect length of stay, amputation rate, or mortality. There was no statistical difference in rate of amputations, length of stay, or mortality based on RHA. Incidence within the province, however, varied significantly based on RHA and ethnicity (P < .05). We determined that regardless of origin before admission, all our patients have equivalent prognosis. Burntwood RHA was found to have substantially higher incidence than the rest of the province, and higher incidence was established among the Aboriginal population.
authors.affiliation: University of Manitoba, Department of Medicine, Winnipeg, Manitoba, Canada.
authors.forename: Edin
authors.initials: E
authors.lastname: Tunovic
authors.forename: Justin
authors.initials: J
authors.lastname: Gawaziuk
authors.forename: Tom
authors.initials: T
authors.lastname: Bzura
authors.forename: John
authors.initials: J
authors.lastname: Embil
authors.forename: Ali
authors.initials: A
authors.lastname: Esmail
authors.forename: Sarvesh
authors.initials: S
authors.lastname: Logsetty
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents