Clinicobacteriological profile, Mortality Predictors and Antimicrobial Resistance in Necrotising Soft Tissue Infections: A prospective study.

Authors

Anjali Anil, Tanvi Vashist, Divya Nair, Karthick Rangasamy, Pallab Ray, Tanvi Kiran, Cherring Tandup, Rishikesh Prasad, Archana Angrup

Published in

Indian journal of medical microbiology. Pages 101334. Nov 09, 2026. Epub Nov 09, 2026.

Abstract

Necrotising soft tissue infections (NSTIs) are rapidly progressive infections requiring prompt diagnosis and management. This study assessed predictors of mortality, microbiological spectrum, antimicrobial resistance patterns, and differences between polymicrobial and monomicrobial NSTIs in a prospective manner.
This study enrolled patients aged 15 years or older with clinically suspected NSTIs who presented between March 2022 and February 2023. Clinical, laboratory, surgical, and outcome data were collected. Tissue and pus samples were processed for aerobic and anaerobic cultures. Antimicrobial susceptibility testing was performed according to CLSI guidelines. Mortality-associated factors were analysed using univariate analysis, binary logistic regression, and survival analysis.
Eighty-seven patients were included, predominantly male (87.3%), with a median age of 47.5 years. Extremities were most commonly affected. The mortality rate of this cohort was 25.3%. Polymicrobial infections predominated (49.4%), while monomicrobial NSTIs were associated with higher mortality (p = 0.022). Gram-negative organisms, particularly Acinetobacter baumannii and Escherichia coli, were the most frequent pathogens. Obligate anaerobes were significantly associated with polymicrobial infections. Chronic liver disease (p = 0.003) and systemic toxicity (p = 0.018) independently predicted mortality, whereas higher haemoglobin levels were protective. High antimicrobial resistance was observed, including carbapenem-resistant A. baumannii and Enterobacterales. Among the anaerobes, resistance to clindamycin and cefoxitin, along with reduced susceptibility to metronidazole, was reported.
NSTIs remain associated with substantial mortality, especially in monomicrobial infections due to multidrug-resistant Gram-negative pathogens. Early recognition, prompt surgery, and region-specific empirical antimicrobial therapy are crucial for improving outcomes.

PMID:
43003286
Bibliographic data and abstract were imported from PubMed on 10 Nov 2026.

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