Perfil bacteriológico e regimes antibióticos utilizados no tratamento da Gangrena de Fournier
DOI:
https://doi.org/10.34119/bjhrv6n1-265Keywords:
Gangrena de Fournier, microbiologia, bacteriologia, antibióticosAbstract
Objetivo: determinar o perfil bacteriológico e os regimes antibióticos utilizados para o tratamento da Gangrena de Fournier. Método: Foi realizada uma Revisão Bibliográfica. Os artigos foram selecionados a partir das seguintes bases de dados: ProQuest (https://www.proquest.com/), PubMed (https://pubmed.ncbi.nlm.nih.gov/), e ScienceDirect (https://www.sciencedirect.com/) em espanhol ou inglês, usando descritores e operadores booleanos AND e OR. Resultados: O perfil bacteriológico da gangrena de Fournier é principalmente do tipo polimicrobiano, com maior presença de bactérias gram-negativas e anaeróbicas, entre as quais as mais importantes são Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae e Bacteroides fragilis. As bactérias gram-positivas, as mais proeminentes são Staphylococcus aureus e Streptococcus spp. Há também bactérias multiresistentes, principalmente Escherichia coli blee e Staphylococcus aureus resistente à meticilina. Quanto ao tratamento, existem múltiplos regimes antibióticos, sendo o mais amplamente utilizado e recomendado: cefalosporina de terceira geração mais aminoglicosídeo mais metronidazol. Conclusão: a gangrena de Fournier é uma patologia rara, mas muito devastadora, difícil de tratar e com um prognóstico ruim. A infecção é principalmente polimicrobiana e o tratamento antibiótico necessário é de amplo espectro.
References
Agwu, N., Muhammad, A., Abdullahi, A.-A., Bashir, B., Legbo, J., & Mungadi, I. (2020). Pattern and outcome of management of Fournier’s gangrene in a resource-constraint setting. Urology Annals, 12(3), 248. https://doi.org/10.4103/UA.UA_62_19
Auerbach, J., Bornstein, K., Ramzy, M., Cabrera, J., Montrief, T., & Long, B. (2020). Fournier Gangrene in the Emergency Department: Diagnostic Dilemmas, Treatments and Current Perspectives. Open Access Emergency Medicine, Volume 12, 353–364. https://doi.org/10.2147/OAEM.S238699
Becerra, C. M. C., Jaeger, C. D., Rose, J. R., Beecroft, N. J., Shah, N. C., Posid, T., Jenkins, L. C., & Baradaran, N. (2020). Microorganisms and Antibiogram Patterns in Fournier’s Gangrene: Contemporary Experience from a Single Tertiary Care Center. Journal of Urology, 204(6), 1249–1254. https://doi.org/10.1097/JU.0000000000001194
Chernyadyev, S. A., Ufimtseva, M. A., Vishnevskaya, I. F., Bochkarev, Y. M., Ushakov, A. A., Beresneva, T. A., Galimzyanov, F. V., & Khodakov, V. V. (2018). Fournier’s Gangrene: Literature Review and Clinical Cases. Urologia Internationalis, 101(1), 91–97. https://doi.org/10.1159/000490108
Cipriani, C., Iacovelli, V., Sandri, M., Bertolo, R., Maiorino, F., Antonucci, F., Micali, S., Rocco, B., Puliatti, S., Ferrarese, P., Benedetto, G., Minervini, A., Cocci, A., Pastore, A. L., Al Salhi, Y., Antonelli, A., Morena, T., Volpe, A., Poletti, F., … Bove, P. (2022). The microbiological profile of patients with Fournier’s gangrene: A retrospective multi-institutional cohort study. Urologia Journal, 89(3), 437–443. https://doi.org/10.1177/03915603211018441
Çitgez, S., Demirdağ, Ç., Özkaya, M., Selçuk, B., & Erözenci, A. (2019). Fournier’s Gangrene: Analysis of Risk Factors Affecting Mortality in a Tertiary Urology Referral Center. Journal of Urological Surgery, 6(3), 196–200. https://doi.org/10.4274/jus.galenos.2019.2642
Creta, M., Sica, A., Napolitano, L., Celentano, G., La Rocca, R., Capece, M., Calogero, A., Califano, G., Vanni, L., Mangiapia, F., Arcaniolo, D., Spirito, L., Fusco, F., De Sio, M., Imbimbo, C., Mirone, V., Sagnelli, C., & Longo, N. (2021). Fournier’s Gangrene in Patients with Oncohematological Diseases: A Systematic Review of Published Cases. Healthcare, 9(9), 1123. https://doi.org/10.3390/healthcare9091123
Egas-Ortega, W., Granja-Rousseau, I., Luzuriaga-Graf, J., Egas-Romero, W., & Moncayo, C. (2017). Características de los casos de gangrena de Fournier atendidos en el Hospital Luis Vernaza de Guayaquil-Ecuador. 6.
El-Qushayri, A. E., Khalaf, K. M., Dahy, A., Mahmoud, A. R., Benmelouka, A. Y., Ghozy, S., Mahmoud, M. U., Bin-Jumah, M., Alkahtani, S., & Abdel-Daim, M. M. (2020). Fournier’s gangrene mortality: A 17-year systematic review and meta-analysis. International Journal of Infectious Diseases, 92, 218–225. https://doi.org/10.1016/j.ijid.2019.12.030
Fernandez-Alcaraz, D. A., Guillén-Lozoya, A. H., Uribe-Montoya, J., Romero-Mata, R., & Gutierrez-González, A. (2019). Etiology of Fournier gangrene as a prognostic factor in mortality: Analysis of 121 cases. Actas Urológicas Españolas (English Edition), 43(10), 557–561. https://doi.org/10.1016/j.acuroe.2019.05.010
Grigore, N., Pîrvuț, V., Mihai, I., & Hașegan, A. (2017). The Fournier Gangrene—A Life-threthening Disease. 16, 5.
Hagedorn, J. C., & Wessells, H. (2017). A contemporary update on Fournier’s gangrene. Nature Reviews Urology, 14(4), 205–214. https://doi.org/10.1038/nrurol.2016.243
Huayllani, M. T., Cheema, A. S., McGuire, M. J., & Janis, J. E. (2022). Practical Review of the Current Management of Fournier’s Gangrene. Plastic and Reconstructive Surgery - Global Open, 10(3), e4191. https://doi.org/10.1097/GOX.0000000000004191
Inácio, M. F., Lima, R. P., Neto, S. R., Lopes, F. A., Pantaroto, M., & de Sousa, A. V. (2020). Epidemiological study on Fournier syndrome in a tertiary hospital in Jundiaí-SP from October 2016 to October 2018†. Journal of Coloproctology, 40(01), 037–042. https://doi.org/10.1016/j.jcol.2019.10.005
Ioannidis, O., Kitsikosta, L., Tatsis, D., Skandalos, I., Cheva, A., Gkioti, A., Varnalidis, I., Symeonidis, S., Savvala, N. A., Parpoudi, S., Paraskevas, G. K., Pramateftakis, M. G., Kotidis, E., Mantzoros, I., & Tsalis, K. G. (2017). Fournier’s Gangrene: Lessons Learned from Multimodal and Multidisciplinary Management of Perineal Necrotizing Fasciitis. Frontiers in Surgery, 4, 36. https://doi.org/10.3389/fsurg.2017.00036
Kranz, J., Schlager, D., Anheuser, P., Mühlstädt, S., Brücher, B., Tanja, F., Barski, D., Mayr, R., Lunacek, A., Macharia-Nimietz, E. F., Steffens, J. A., Grolle, J., Pelze, A., & Schneidewind, L. (2018). Desperate need for better management of Fournier’s Gangrene. Central European Journal of Urology. https://doi.org/10.5173/ceju.2018.1740
Kuzaka, B., Wróblewska, M. M., Borkowski, T., Kawecki, D., Kuzaka, P., Młynarczyk, G., & Radziszewski, P. (2018). Fournier’s Gangrene: Clinical Presentation of 13 Cases. Medical Science Monitor, 24, 548–555. https://doi.org/10.12659/MSM.905836
Montrief, T., Long, B., Koyfman, A., & Auerbach, J. (2019). Fournier Gangrene: A Review for Emergency Clinicians. The Journal of Emergency Medicine, 57(4), 488–500. https://doi.org/10.1016/j.jemermed.2019.06.023
Sedano-Basilio, J. E., Cornejo-Dávila, V., Trujillo-Ortiz, L., Cantellano-Orozco, M., Fernández-Noyola, G., Martínez-Arroyo, C., Morales-Montor, J. G., & Pacheco-Gahbler, C. (2016). Experiencia y revisión de la literatura en el manejo de gangrena de Fournier en una institución, 2008-2015. Revista Mexicana de Urología, 76(1), 29–35. https://doi.org/10.1016/j.uromx.2015.12.003
Singh, A., Ahmed, K., Aydin, A., Khan, M. S., & Dasgupta, P. (2016). Fournier’s gangrene. A clinical review. Archivio Italiano Di Urologia e Andrologia, 88(3), 157. https://doi.org/10.4081/aiua.2016.3.157
Sockkalingam, V. S., Subburayan, E., Velu, E., Rajashekar, S. T., & Swamy, A. M. (2018). Fournier’s gangrene: Prospective study of 34 patients in South Indian population and treatment strategies. Pan African Medical Journal, 31. https://doi.org/10.11604/pamj.2018.31.110.15495
Vargas Rubio, T., Mora Agüero, S. D. los Á., & Zeledón Aguilera, A. S. (2019). Gangrena de Fournier: Generalidades. Revista Medica Sinergia, 4(6), 100–107. https://doi.org/10.31434/rms.v4i6.217
Voelzke, B. B., & Hagedorn, J. C. (2018). Presentation and Diagnosis of Fournier Gangrene. Urology, 114, 8–13. https://doi.org/10.1016/j.urology.2017.10.031
Yilmazlar, T., Gulcu, B., Isik, O., & Ozturk, E. (2017). Microbiological aspects of Fournier’s gangrene. International Journal of Surgery, 40, 135–138. https://doi.org/10.1016/j.ijsu.2017.02.067
