A Prospective Study of Patient with Necrotising Fasciitis in Relation to Clinical Feature and Bacteriological Profile

Abstract

: Necrotizing fasciitis (NF) is a rapidly progressive soft tissue infection associated with significant morbidity and mortality, necessitating early diagnosis and prompt surgical intervention. This prospective observational study was conducted to evaluate the clinical presentation, bacteriological profile, management, and outcomes of patients with NF admitted to a tertiary care teaching hospital in eastern Uttar Pradesh, India. A total of 140 patients with clinically diagnosed NF were enrolled. Demographic details, clinical features, comorbidities, microbiological findings, treatment, complications, and outcomes were recorded and analysed. Older adults were most commonly affected, with a slight male predominance. Diabetes mellitus was the most frequent comorbidity. Pain and swelling were present in all patients, while the perineum and lower limbs were the most commonly involved sites. Culture positivity was observed in 62.9% of cases, with Staphylococcus aureus being the most common isolate, followed by Klebsiella spp. and Escherichia coli . Multiple surgical debridement was the most frequently performed procedure, and more than half of the patients required intensive care. The overall recovery rate was 95%. Advanced age, diabetes mellitus, hypertension, chronic kidney disease, alcohol use, smoking, culture positivity, ICU admission, septic shock, acute respiratory distress syndrome, and multiple organ dysfunction syndrome were significantly associated with mortality. Early diagnosis, prompt aggressive surgical debridement, culture-guided antimicrobial therapy, and intensive supportive care remain the key determinants of favourable outcomes in patients with necrotizing fasciitis.