{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:44:50Z","timestamp":1777934690004,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T00:00:00Z","timestamp":1674777600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surgical Infections"],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Necrotizing fasciitis (NF) is a potentially fatal soft tissue infection. Four types of pathogens can be distinguished in the pathogen spectrum, although there are strong regional differences with regard to the most common pathogens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>All cases of NF between 2003 and 2021 with an identified causative agent were analyzed retrospectively. The cases were divided into three groups: polymicrobial, gram-positive and gram-negative. Demographic factors, localization of infection, inflammatory parameters, and clinical outcome were compared between the three groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 95 cases were analyzed, 41% of which were caused by multiple pathogens. A gram-positive pathogen was reported in 40% of cases and a gram-negative pathogen in 19%. There were significant differences between the three groups with respect to age (with patients in the gram-negative group being on average the oldest) and intensive care unit admissions (which was most frequent in the polymicrobial group).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The pathogen spectrum of NF has rarely been studied in a large patient population. Gram-positive pathogens account for the majority of monomicrobial infections in our study. Nevertheless, we recommend calculated broad-spectrum antibiotic therapy given the high number of polymicrobial infections and gram-negative infections. Gram-negative infections may be associated with increased mortality, elevated procalcitonin levels, and are relatively frequent in NF of the lower extremities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/sur.2022.317","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T16:57:12Z","timestamp":1671123432000},"page":"46-51","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Causative Micro-Organisms in Necrotizing Fasciitis and their Influence on Inflammatory Parameters and Clinical Outcome"],"prefix":"10.1177","volume":"24","author":[{"given":"David","family":"Breidung","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive, and Hand Surgery, Center for Severe Burn Injuries, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum N\u00fcrnberg, Nuremberg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asja T.","family":"Malsagova","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, and Hand Surgery, Center for Severe Burn Injuries, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum N\u00fcrnberg, Nuremberg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexios","family":"Loukas","sequence":"additional","affiliation":[{"name":"Department of Genetics, Development, and Molecular Biology, School of Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moritz","family":"Billner","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, and Hand Surgery, Center for Severe Burn Injuries, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum N\u00fcrnberg, Nuremberg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Aurnhammer","sequence":"additional","affiliation":[{"name":"Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum N\u00fcrnberg, Nuremberg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bert","family":"Reichert","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, and Hand Surgery, Center for Severe Burn Injuries, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum N\u00fcrnberg, Nuremberg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis-Fivos","family":"Megas","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, and Hand Surgery, Center for Severe Burn Injuries, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum N\u00fcrnberg, Nuremberg, 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