A Study of Bacteriological Profile of Gas Gangrene and Fournier’s Gangrene at a Tertiary Care Centre in Central India

Abstract

Background: Gas gangrene is a life threatening condition which is predominantly caused by Clostridium spp. It is typically characterized by the presence of gas in tissues and necrotising myositis. Fournier’s gangrene (FG) is a rapidly progressive necrotizing fasciitis of the genitalia, perineum and abdominal wall that primarily involve subcutaneous tissues.1 Materials and Methods: A total of 264 wound swabs were processed for suspected gas gangrene and fournier’s gangrene. Out of these, 95 swabs were positive for gas gangrene (62) and Fournier’s gangrene (33). Aerobic culture was done on sheep blood agar (BA) and MacConkey agar (MA). Antibiotic sensitivity pattern of the aerobic organisms was also studied.4 For anaerobic culture, the swabs were inoculated in RCM (Robertson’s cooked meat) medium along with direct culture on neomycin blood agar (NBA). Results: There was a rise in cases of Gas gangrene and Fournier’s gangrene from 2012 to 2016 from 12.90% to 40.32% and 9.09% to 30.30% respectively. Among various antibiotics studied, maximum sensitivity was seen towards imipenem, followed by cefazolin and cefepime in Gram negative species and towards linezolid in Gram positive species in Fournier’s gangrene. In gas gangrene, maximum sensitivity was seen towards imipenem followed by piperacillin – tazobactum followed by cotrimoxazole in Gram negative species and towards linezolid in Gram positive species. Out of the 62 gas gangrene cases, E.coli (24.19%) was the commonest organism in aerobic infection in gas gangrene followed by Staphylococcus aureus (19.35%). Conclusion: There is a need to consider aerobic infections along with anaerobic infections in combatting serious infections like gas gangrene and Fournier’s gangrene. Early diagnosis and antimicrobial therapy towards such aerobic organisms will improve the prognosis of these patients and reduce mortality.