#Etiology, characteristics, and #outcomes of community-onset #necrotizing #fasciitis in #Korea: A multicenter study (PLoS One, abstract)

[Source: PLoS One, full page: (LINK). Abstract, edited.]


Etiology, characteristics, and outcomes of community-onset necrotizing fasciitis in Korea: A multicenter study

Tark Kim, Seong Yeon Park, Yee Gyung Kwak, Jiwon Jung, Min-Chul Kim, Seong-Ho Choi, Shi Nae Yu, Hyo-Lim Hong, Yong Kyun Kim, Se Yoon Park, Eun Hee Song, Ki-Ho Park, Oh Hyun Cho, Sang-Ho Choi , the Korean SSTI Study Group

Published: June 20, 2019 / DOI: https://doi.org/10.1371/journal.pone.0218668




Necrotizing fasciitis (NF) is a serious skin and soft tissue infection causing high mortality. Investigating region specific epidemiologic factors associated with NF is important for establishing appropriate treatment strategies. This multicenter study was done to provide an update of the microbial etiology, clinical characteristics, and outcomes of NF in Korea.

Materials and methods

A retrospective cohort of adult patients with NF was established using patient data from 13 general hospitals between January 2012 and December 2015 in Korea. We evaluated microbial etiology and clinical characteristics to identify risk factors associated with in-hospital mortality; analyses were performed using binary logistic regression models.


A total of 161 patients with NF were included. The most common underlying disease was diabetes mellitus (66 cases, 41.0%). A total of 148 organisms were isolated from 119 (73.9%) patients. Enteric Gram-negative organisms (36 patients) were the most common pathogen, followed by Staphylococcus aureus (30 patients) and streptococci (28 patients). Methicillin-resistant Staphylococcus aureus (MRSA) was identified in 6.2% (10/161) of patients. Of 37 enteric Gram-negative isolates tested, 26 (70.3%) isolates were susceptible to ceftriaxone. The in-hospital mortality rate was 22.4%. Intensive care unit admission, septic shock, and Gram-negative organism infections were significantly associated with in-hospital mortality, and surgery was not a favorable prognostic factor.


As initial empirical antibiotics, glycopeptides against MRSA and broad-spectrum antibiotics against third-generation cephalosporin-resistant organisms should be considered for patients with community-onset NF in Korea.


Citation: Kim T, Park SY, Kwak YG, Jung J, Kim M-C, Choi S-H, et al. (2019) Etiology, characteristics, and outcomes of community-onset necrotizing fasciitis in Korea: A multicenter study. PLoS ONE 14(6): e0218668. https://doi.org/10.1371/journal.pone.0218668

Editor: Marc O. Siegel, George Washington University, UNITED STATES

Received: December 30, 2018; Accepted: June 6, 2019; Published: June 20, 2019

Copyright: © 2019 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files.

Funding: TK received the Soonchunhyang University Research Fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Keywords: Necrotizing fasciitis; Staphylococcus aureus; Antibiotics; MRSA; S. Korea.


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Giuseppe Michieli

I am an Italian blogger, active since 2005 with main focus on emerging infectious diseases such as avian influenza, SARS, antibiotics resistance, and many other global Health issues. Other fields of interest are: climate change, global warming, geological and biological sciences. My activity consists mainly in collection and analysis of news, public services updates, confronting sources and making decision about what are the 'signals' of an impending crisis (an outbreak, for example). When a signal is detected, I follow traces during the entire course of an event. I started in 2005 my blog ''A TIME'S MEMORY'', now with more than 40,000 posts and 3 millions of web interactions. Subsequently I added an Italian Language blog, then discontinued because of very low traffic and interest. I contributed for seven years to a public forum (FluTrackers.com) in the midst of the Ebola epidemic in West Africa in 2014, I left the site to continue alone my data tracking job.