The evaluation of microbiology and prognosis of fournier's gangrene in past five years

Objectives: Fournier's gangrene (FG) is an devastating disease that affects the perineum and genitourinary region, and is commonly a result of poly-microbial infection. This study is aimed to determine the correlation between micrology and prognosis of FG in the past five years.

Methods: This study was a retrospective cohort study that was designed to study the trends in micrology and prognosis of FG. From the PubMed database, articles published in the recent 5 years (from Jan1(st), 2009 to Dec 31(st), 2013) were reviewed. A total of 19 articles (each with n > 30 and with thorough data descriptions in the topic of Fournier's gangrene), were enrolled in this study. The consolidated data was further analyzed by commercial statistical software (SPSS for Windows).

Results: The twenty-two studies have covered FG cases from year 1981 to 2011, with a mean duration of 9.2 years. The total number of cases is 4,365. Majority of the cases are male (84.1%). The mean age and mortality rate is 51.8 ± 5 years old and 11.1 ± 8.9%, respectivly. The most commonly found pathogen is poly-microbial organism (54%), followed by Escherichia coli (46.6%) and Streptococcus (36.8%). The major risk factors are diabetes (43.7%), Body mass index of > 30 (40.7%), and hypertension (38.1%). Mortality rate in older patient group (age > 51.8 years old) is significantly higher than those of the younger group (22% vs. 5.5%, p = 0.0001).

Conclusions: Older patients with genital or perineal pain should be examined for crepitus dermis. When a patient is diagnosed with FG, swift consultation with surgeons and administration of broad-spectrum antibiotics are required in order to save the patient's live.