{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T09:00:56Z","timestamp":1790413256503,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"vor","delay-in-days":268,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPG6P0031"],"award-info":[{"award-number":["CMRPG6P0031"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPG6N0061"],"award-info":[{"award-number":["CMRPG6N0061"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPG6L0071"],"award-info":[{"award-number":["CMRPG6L0071"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPG6H0641"],"award-info":[{"award-number":["CMRPG6H0641"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Canadian Journal of Infectious Diseases and Medical Microbiology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Necrotizing fasciitis (NF) caused by\n                      <jats:italic>Vibrio<\/jats:italic>\n                      species is a rapidly progressing, life\u2010threatening infection. The purposes of this study were to characterize polymicrobial\n                      <jats:italic>Vibrio<\/jats:italic>\n                      NF and compare its clinical features, microbiology, antimicrobial therapy, and outcomes with those of monomicrobial\n                      <jats:italic>Vibrio<\/jats:italic>\n                      NF, and to evaluate the effective usage of empirical antibiotics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      One hundred and ninety\u2010four patients surgically confirmed with\n                      <jats:italic>Vibrio<\/jats:italic>\n                      NF were retrospectively reviewed, in which 180 (92.8%) patients were infected by\n                      <jats:italic>Vibrio vulnificus<\/jats:italic>\n                      . There were 179 patients (92.3%) with a monomicrobial infection and 15 (7.7%) with polymicrobial infections. Clinical characteristics, outcomes, laboratory data, and antibiotic usage were analyzed and compared between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010nine patients with\n                      <jats:italic>Vibrio<\/jats:italic>\n                      NF died (14.9%). Mortality was 15.6% (28\/179) in the monomicrobial group and 6.7% (1\/15) in the polymicrobial group. Among the 15 polymicrobial cases, 14 were caused by\n                      <jats:italic>Vibrio vulnificus<\/jats:italic>\n                      and 1 by\n                      <jats:italic>Vibrio parahaemolyticus<\/jats:italic>\n                      . Gout was more frequently observed in the polymicrobial group (4\/15) than in the monomicrobial group (11\/179).\n                      <jats:italic>Vibrio<\/jats:italic>\n                      isolates showed high susceptibility to third\u2010generation cephalosporins, fluoroquinolones, and tetracyclines. Effective antimicrobial therapy was associated with lower mortality (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002) and lower amputation rates (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Polymicrobial\n                      <jats:italic>Vibrio<\/jats:italic>\n                      NF was uncommon but was not clinically less severe than monomicrobial\n                      <jats:italic>Vibrio<\/jats:italic>\n                      NF in this 20\u2010year cohort. Patients with polymicrobial infection more frequently had gout, suggesting a potential clinical association that warrants further investigation. These findings indicate that suspected polymicrobial\n                      <jats:italic>Vibrio<\/jats:italic>\n                      NF should be treated with the same urgency as monomicrobial disease, with prompt surgery, intensive care, and empirical antimicrobial therapy covering both\n                      <jats:italic>Vibrio<\/jats:italic>\n                      species and relevant copathogens.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/cjid\/9414923","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T08:56:07Z","timestamp":1790412967000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antibiotic Selection and Outcomes in Patients With Monomicrobial and Polymicrobial\n                    <i>Vibrio<\/i>\n                    Necrotizing 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