J 2023

Vibrio vulnificus-Induced Necrotizing Fasciitis Complicated by Multidrug-Resistant Acinetobacter baumannii Infection: Efficacy of Chemical Necrectomy Using 40% Benzoic Acid

LIPOVÝ, Břetislav, Radomír MAGER, Filip RAŠKA, Marketa HANSLIANOVA, Josef BLAZEK et. al.

Basic information

Original name

Vibrio vulnificus-Induced Necrotizing Fasciitis Complicated by Multidrug-Resistant Acinetobacter baumannii Infection: Efficacy of Chemical Necrectomy Using 40% Benzoic Acid

Authors

LIPOVÝ, Břetislav (203 Czech Republic, belonging to the institution), Radomír MAGER (203 Czech Republic, belonging to the institution), Filip RAŠKA (203 Czech Republic, belonging to the institution), Marketa HANSLIANOVA (203 Czech Republic), Josef BLAZEK (203 Czech Republic), Hana KREMECKOVA (203 Czech Republic), Ivan SUCHÁNEK (203 Czech Republic) and Martin HLADÍK (703 Slovakia, guarantor, belonging to the institution)

Edition

INTERNATIONAL JOURNAL OF LOWER EXTREMITY WOUNDS, THOUSAND OAKS, SAGE PUBLICATIONS INC, 2023, 1534-7346

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 1.700 in 2022

RIV identification code

RIV/00216224:14110/23:00134616

Organization unit

Faculty of Medicine

UT WoS

000643459200001

Keywords in English

Vibrio vulnificus; skin and soft tissue infection; necrotizing fasciitis; multidrug-resistant bacteria; chemical necrectomy

Tags

Tags

International impact, Reviewed
Změněno: 26/1/2024 09:24, Mgr. Tereza Miškechová

Abstract

V originále

Necrotizing fasciitis is a life-threatening skin and soft tissue infection associated with high morbidity and mortality in adult patients. This infection can present as either type 1 infection caused by a mixed microflora (Streptococci, Enterobacteriacae, Bacteroides sp., and Peptostreptococcus sp.), most commonly developing in patients after surgery or in diabetic patients, or as type 2. The latter type is monomicrobial and, usually, caused by group A Streptococci. Rarely, this type can be also caused by other pathogens, such as Vibrio vulnificus. V vulnificus is a small mobile Gram-negative rod capable of causing 3 types of infections in humans-gastroenteritis, primary infection of the vascular bed, and wound infections. If infecting a wound, V vulnificus can cause a life-threatening condition-necrotizing fasciitis. We present a rare case of necrotizing fasciitis developing after an insect bite followed by exposure to the seawater. Rapid propagation of the infectious complication in the region of the right lower limb led to a serious consideration of the necessity of amputation. Due to the clearly demarcated necroses and secondary skin and soft tissue infection caused by a multiresistant strain of Acinetobacter baumannii, we, however, resorted to the use of selective chemical necrectomy using 40% benzoic acid-a unique application in this kind of condition. The chemical necrectomy was successful, relatively gentle and thanks to its selectivity, vital parts of the limb remained preserved and could have been subsequently salvaged at minimum blood loss. Moreover, the antimicrobial effect of benzoic acid led to rapid decolonization of the necrosis and wound bed preparation, which allowed us to perform defect closure using split-thickness skin grafts. The patient subsequently healed without further complications and returned to normal life.

Links

NU20-05-00166, research and development project
Name: Nové přístupy k hojení infikovaných ran pomocí hydrogelů z přírodní pryskyřice Gum Karaya modifikovaných inovativními komponenty cílenými na multirezistentní kmeny bakterií (Acronym: NPHIRPHGK)
Investor: Ministry of Health of the CR, Subprogram 1 - standard