# Clinical Profile and Outcomes of Patients With Necrotizing Soft Tissue Infections: A Prospective Observational Study

## TL;DR

This study examines the clinical features and outcomes of patients with necrotizing soft tissue infections, highlighting risk factors and the importance of timely treatment.

## Contribution

The study provides new insights into the microbiological spectrum and factors influencing mortality in necrotizing soft tissue infections.

## Key findings

- E. coli was the most common isolate in both types of necrotizing soft tissue infections.
- High APACHE II and LRINEC scores are associated with increased mortality risk.
- Prompt multidisciplinary management improves outcomes and reduces mortality.

## Abstract

Introduction: Necrotising soft tissue infection (NSTI) is uncommon, and its management is complex due to its diverse clinical presentations, multiple associated comorbidities, and a wide range of potential microbial aetiologies. This study aims to illustrate the clinical profile, microbiological spectrum, and factors affecting mortality among patients with NSTI.

Methods: This single-centre, hospital-based, prospective observational study included all patients with NSTI aged 18 years or older. The primary outcome was the impact of time to surgery on mortality. Secondary outcomes included identifying the aetiology, microbiological flora, major co-morbidities, and overall outcomes in these patients.

Results: During the study period, 87 patients were enrolled. There were 65 (74.7%) male and 22(25.3%) female patients with an age range of 18 years to 88 years. Postoperatively, 18 patients succumbed to death, while 69 survived. Overall, the average timing of the first intervention after admission was six hours, with no significant statistical difference between the survivor and non-survivor group (p-value = 0.575). Our study found types I and II infections in 26 (34.5%) and 45 (65.4%) patients, respectively, and Escherichia coli (E. coli) was the most common isolate in both types. The antibiotic resistance pattern revealed increased resistance to third-generation cephalosporins and fluoroquinolones for the Enterobacteriaceae group and E. coli.

Conclusion: High APACHE II and LRINEC scores, anaemia, hypoalbuminemia, and high creatinine are associated with a higher risk of death. Prompt multidisciplinary management of these patients significantly improves outcomes and reduces mortality.