Fournier's gangrene. Etiology, diagnosis, and treatment

Jorge Luis Zambrano Sánchez — 2024-11-28

Background: Fournier's Gangrene (FG) is a severe necrotizing infection of soft tissues, primarily affecting the perineum, genitals, and lower abdomen. Although rare, its high mortality and rapid progression demand a comprehensive understanding of its management. Objective: This review aims to evaluate the clinical, diagnostic, and therapeutic aspects of Fournier's gangrene, providing an updated overview of its management and outcomes. Methodology: A comprehensive literature review was conducted, focusing on recent and relevant studies on Fournier's gangrene. Articles addressing clinical management, diagnosis, therapeutic interventions, and associated comorbidities were evaluated. Results: The reviewed studies indicate that Fournier's gangrene is often associated with comorbidities such as diabetes mellitus and urological diseases. Early detection and prompt surgical intervention are crucial for improving prognosis. Standard treatment involves aggressive surgical debridement, broad-spectrum antibiotic therapy, and management of underlying conditions. Despite advancements in treatment strategies, mortality rates remain high. Conclusion: Fournier's gangrene is a medical emergency that requires rapid intervention and a multidisciplinary approach. The combination of early debridement, appropriate antibiotic therapy, and management of comorbidities is essential for improving outcomes and reducing mortality. Ongoing research is needed to optimize treatment strategies and improve the quality of life for affected patients. General area of study: medicine. Specific study area: general surgery and coloproctology. Type of study: narrative review.

Prevalence of beta-lactamases in urine cultures of outpatients at the Vicente Corral Moscoso Hospital, period 2019 – 2022

María Fernanda Guamán Sánchez — 2024-11-30

Introduction: In recent years, a significant increase in the prevalence of resistant uropathies has been observed, with extended-spectrum beta-lactamase-producing bacteria being one of the most important groups, due to their mechanism of hydrolyzing beta-lactam antibiotics. Objective: To determine the prevalence of beta-lactamases in urine cultures of outpatients at the Vicente Corral Moscoso Hospital, period 2019 – 2022. Methodology: The methodology is quantitative research, with a cross-sectional, observational, descriptive-explanatory study. It was conducted at the Vicente Corral Moscoso Hospital, the study universe constitutes all the urine cultures of patients seen in the outpatient clinic in the period 2019 to 2022, with a total of 903 patients, the variables to be studied are: Age, sex, isolated microorganism, resistance to beta-lactam antibiotics, resistance to other antibiotics. The SPSS statistical package was used for data analysis. Results: the population was female with 80.3 %. Among the main bacteria producing extended-spectrum beta-lactamase in urine cultures from outpatients, Escherichia coli was identified as the most common bacterium in urine cultures with a total of 89.8%; however, only 21.0% reported positive for beta-lactamase, as well as 7.7% of Klebsiella oxytoca and 58.1% of Klebsiella pneumoniae. Conclusion: the prevalence and patterns of resistance and sensitivity of bacteria producing extended-spectrum beta-lactamases are comparable with both local and international epidemiology.

Anatomía Digital

Fournier's gangrene. Etiology, diagnosis, and treatment

Prevalence of beta-lactamases in urine cultures of outpatients at the Vicente Corral Moscoso Hospital, period 2019 – 2022