腸球菌屬在佛尼爾氏壞疽病人身上可能致命

張哲綱、林宗彥、歐建慧

國立成功大學醫學院附設醫院 泌尿科

Enteroccocus Species Can Be Fatal In Patients With Fournier’s Gangrene

Che-Kang Chang, Tsung-Yen Lin, and Chien-Hui Ou

Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan

Purpose: Fournier’s Gangrene is a fatal disease. However, several factors may play important roles in causing death. The study of pathogen type on patients’ wound is the easiest way to analyzing the connection to Fournier’s Gangrene. Thus, we tried efforts to find out the most decisive pathogen which contribute to most mortality.

Materials and Methods: We analyzed the total 100 patients from 1996 to 2018 in National Cheng Kung University Hospital and listed out their wound culture and correlating data including simplified Fournier’s Gangrene Severity Index (SFGSI), time to first surgery, numbers of debridement, admission days and the most importantly, mortality cases.

Results: We generally put the whole database into 2 parts: wounds with Enteroccocus species and wounds without Enteroccocus species. We found that the group with Enteroccocus species contributed to more mortality cases than the group without Enteroccocus species (p = 0.002). We further analyzed if former 50 cases would have poorer outcome than the latter 50 cases since the progression of medicine may be a confounding factor on the prognosis of the disease. However, there was no difference between the former and latter groups.

Conclusions: From our single-center study, in patients with Fournier’s Gangrene whose wound culture revealed Enteroccocus species growth may represent higher mortality rate. The awareness of this kind of pathogen would be critical to doctors of primary care.