RESEARCH ARTICLE
Seasonal Variation of Group a Streptococcus (GAS) – Related Necrotising Fasciitis Cases in a UK Teaching Hospital
E. Gkrania-Klotsas1, *, R.C. Chew2, K. Vrotsou3
Article Information
Identifiers and Pagination:
Year: 2008Volume: 2
First Page: 1
Last Page: 7
Publisher ID: TOIDJ-2-1
DOI: 10.2174/1874279300802010001
Article History:
Received Date: 20/10/2007Revision Received Date: 16/11/2007
Acceptance Date: 18/11/2007
Electronic publication date: 28/3/2008
Collection year: 2008
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Objectives:
Necrotizing fasciitis is a diverse syndrome primarily involving the fascia but also occasionally the overlying skin and underlying muscles. Non-necrotising lower limb cellulitis has been reported to have a marked seasonal variation in our area. We are describing the seasonal variation of our necrotising fasciitis cases.
Methods:
The medical records of all the patients that were admitted to our institution with a diagnosis of necrotizing fasciitis, from January 1994 to December 2003, were retrospectively reviewed.
Results:
The necrotising fasciitis infections peaked every year in the spring time, as previously described for cellulitis. The increased incidence was only apparent for group A streptococcus related necrotising fasciitis cases. The diagnosis carried 21% mortality during the same admission. Overall, 39% of the patients had a bad outcome, defined as either death during the same admission, limb amputation or severe disability. 73% of patients who experienced a bad outcome were found to have Group A streptococcus compared to only 41% of the patients in the good outcome group.
Conclusions:
A seasonal variation was noted for Group A streptococcus associated necrotising fasciitis, that remains a lethal condition. As patients with Group A streptococcus associated necrotising fasciitis tend to have a worse outcome in our series, increased awareness and targeted antibiotic therapy may enhance clinical outcomes. Knowledge of microbiology might also inform infection control decisions.