The evaluation of microbiology and Fournier's gangrene severity index in 27 patients

Abstract

OBJECTIVES: The objectives of this study were to identify the causative microorganisms and factors associated with survival in patients with Fournier's gangrene and to determine the accuracy of the Fournier's gangrene severity index. MATERIALS AND METHODS: We retrospectively evaluated 27 patients with Fournier's gangrene who were treated and followed up at our hospital between January 2005 and December 2006. Biochemical, hematologic, and bacteriologic study results at admission and at the final evaluation, etiologic and predisposing factors at admission, physical examination findings, the timing and extent of surgical debridement, and antibiotic therapy used were all recorded. RESULTS: The admission laboratory parameters that were significantly correlated with outcome included urea, creatinine, sodium, and potassium; at the final evaluation, in addition to these parameters, hematocrit, albumin, and bicarbonate levels were also significantly associated with outcome. The mean Fournier's gangrene severity index score (FGSIS) at admission for survivors was 5.04+/-2.49 compared with 13.6+/-4.61 for non-survivors. There was a strong correlation between the FGSIS and mortality (p<0.0001). Escherichia coli and Pseudomonas aeruginosa were the most commonly isolated microorganisms. CONCLUSIONS: Patient metabolic status and predisposing factors are important in the prognosis of Fournier's gangrene. Hence, we believe that the FGSIS should be used clinically to evaluate therapeutic options and assess results.