Frequency of Common Bacteria and Their Sensitivity to Antibiotics in Necrotizing Fasciitis

Abstract

Background: Necrotizing fasciitis (NF) is a rapidly progressing, life-threatening soft tissue infection with significant morbidity and mortality. Despite its severity, there is limited region-specific data on the causative pathogens and their antimicrobial resistance patterns, which are critical for effective empirical treatment in resource-constrained settings. Objective: To determine the frequency of common bacterial pathogens and their antibiotic sensitivity profiles in necrotizing fasciitis patients, and to assess their distribution across age and gender for guiding appropriate clinical management. Methods: A cross-sectional study was conducted at the Department of General Surgery, MTI/Hayatabad Medical Complex, Peshawar, over six months, including 105 patients aged 18–70 years diagnosed with NF. Patients with other skin infections, malignancies, or prior antibiotic use were excluded. Clinical samples were collected before antibiotic administration and analyzed for culture and sensitivity using CLSI 2015 guidelines. Ethical approval was obtained, and informed consent was taken in accordance with the Declaration of Helsinki. Data were analyzed using SPSS version 23, applying descriptive statistics and chi-square tests, with p < 0.05 considered significant. Results: Proteus was significantly more prevalent in males (68.3%, p = 0.046). E. coli (52.9%, p = 0.002) and Proteus (62.9%, p = 0.001) were most frequent in the 18–30 years age group. Co-Trimoxazole showed high resistance across species, except for Pseudomonas (98.2% sensitivity). Co-Amoxiclav and Cefixime demonstrated high sensitivity against Beta Hemolytic Streptococci (89.0%). Conclusion: The study identifies E. coli, Proteus, and Staphylococcus aureus as common pathogens in NF with concerning resistance trends, reinforcing the need for localized antibiotic protocols and early culture-guided therapy to improve outcomes in clinical practice.