From the Guidelines
Obesity is a significant risk factor for necrotizing soft tissue infection, particularly for mono-microbial necrotizing fasciitis due to Gram-negative pathogens. This is because obesity can lead to immunocompromised states, making individuals more susceptible to severe infections 1. Necrotizing soft tissue infections (NSTIs) are classified into three types, and while type I is often associated with underlying illnesses such as diabetes, type II infections can occur in any age group and in persons without any underlying illness 1. However, mono-microbial necrotizing fasciitis due to Gram-negative pathogens is typically seen in immunocompromised, diabetic, obese, and postoperative patients 1.
Key points to consider:
- Obesity is a risk factor for mono-microbial necrotizing fasciitis due to Gram-negative pathogens 1
- Necrotizing soft tissue infections can be polymicrobial or mono-microbial 1
- Early surgical debridement and broad-spectrum antimicrobial therapy are essential for treatment 1
- Procalcitonin monitoring may be useful to guide antimicrobial discontinuation 1
It is essential to note that while other conditions such as hypertension, hyperthyroidism, pregnancy, and type 1 diabetes may also play a role in the development of necrotizing soft tissue infections, obesity is a significant risk factor, particularly for certain types of infections 1. Patients with obesity should be aware of the risks and take precautions to prevent infections, such as practicing good wound care and seeking prompt medical attention if symptoms occur.
From the Research
Risk Factors for Necrotizing Soft Tissue Infection
The following are potential risk factors for necrotizing soft tissue infection:
- Obesity: According to 2, obesity may present with unique distributions and microbial characteristics in necrotizing soft tissue infections, but it is not clear if it is an independent risk factor 3.
- Diabetes: Studies have shown that diabetes mellitus is a common comorbidity in patients with necrotizing soft tissue infections 4, 5, 6.
- Other factors: Advanced age, having two or more comorbidities, cancer, liver disease, kidney disease, and heart disease have also been identified as risk factors for mortality, morbidity, and discharge to skilled nursing or rehabilitation facility in patients with necrotizing soft tissue infections 5.
Specific Conditions
The following conditions have been studied in relation to necrotizing soft tissue infection:
- Hypertension: There is no direct evidence in the provided studies to suggest that hypertension is a risk factor for necrotizing soft tissue infection.
- Hyperthyroidism: There is no evidence in the provided studies to suggest that hyperthyroidism is a risk factor for necrotizing soft tissue infection.
- Pregnancy: There is no evidence in the provided studies to suggest that pregnancy is a risk factor for necrotizing soft tissue infection.
- Type 1 diabetes (T1D): While diabetes mellitus is a known risk factor, the studies do not specifically distinguish between type 1 and type 2 diabetes.