Intensive Care Medicine

, Volume 41, Issue 8, pp 1506–1508 | Cite as

Management of necrotizing soft tissue infections in the intensive care unit: results of an international survey

  • Nicolas de ProstEmail author
  • Emilie Sbidian
  • Olivier Chosidow
  • Christian Brun-Buisson
  • Roland Amathieu
  • Henri Mondor Hospital Necrotizing Fasciitis Group

Dear Editor,

Necrotizing soft tissue infections (NSTIs) are rare and life-threatening bacterial infections characterized by subcutaneous tissue, fascia, or muscle necrosis. The mortality of NSTIs is high, ranging from 20 % in non-selected patients to up to 50 % in the most severe forms requiring intensive care unit (ICU) admission [1, 2]. Early recognition of NSTI is crucial; however, its management is challenging and requires a coordinated and multidisciplinary approach. Treatment of NSTIs consists of early broad-spectrum antimicrobial therapy together with emergency and aggressive surgical debridement with excision of all necrotic and infected tissues [3]. We aimed to assess the burden of NSTIs and the organization of their early management in ICUs worldwide.

An online self-administered questionnaire was made available on the website of the European Society for Intensive Care Medicine (ESICM,, after approval from members...


Clindamycin Soft Tissue Infection Intensive Care Medicine Surgical Debridement Recent Guideline 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank the European Society of Intensive Care Medicine (ESICM) for endorsing this survey, particularly Guy François for organizational aspects and Profs Jacques Duranteau (Research Committee) and Jan De Waele (Infection Section) for reviewing the questionnaire.

Henri Mondor Hospital Necrotizing Fasciitis Group

Roland Amathieu, Romain Bosc, Christian Brun-Buisson, Olivier Chosidow, Jean-Winoc Decousser, Gilles DHonneur, Marine Desroches, Camille Hua, Raphael Lepeule, Nicolas de Prost, Alain Rahmouni, Emilie Sbidian.

Compliance with ethical standards

Conflicts of interest

The authors have no conflict of interest.

Supplementary material

134_2015_3916_MOESM1_ESM.doc (42 kb)
Supplementary material 1 (DOC 42 kb)


  1. 1.
    Elliott DC, Kufera JA, Myers RA (1996) Necrotizing soft tissue infections. Risk factors for mortality and strategies for management. Ann Surg 224:672–683PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Das DK, Baker MG, Venugopal K (2012) Risk factors, microbiological findings and outcomes of necrotizing fasciitis in New Zealand: a retrospective chart review. BMC Infect Dis 12:348PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, Hirschmann JV, Kaplan SL, Montoya JG, Wade JC (2014) Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of america. Clin Infect Dis 59:e10–e52PubMedCrossRefGoogle Scholar
  4. 4.
    Carapetis JR, Jacoby P, Carville K, Ang SJ, Curtis N, Andrews R (2014) Effectiveness of clindamycin and intravenous immunoglobulin, and risk of disease in contacts, in invasive group a streptococcal infections. Clin Infect Dis 59:358–365PubMedCrossRefGoogle Scholar
  5. 5.
    Hua C, Bosc R, Sbidian E, de Prost N, Jabre P, Chosidow O, Le Cleach L (2015) Interventions for necrotizing soft tissue infections in adults (Protocol). Cochrane Database Syst Rev. doi: 10.1002/14651858.CD011680

Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2015

Authors and Affiliations

  • Nicolas de Prost
    • 1
    • 2
    Email author
  • Emilie Sbidian
    • 3
    • 4
    • 5
  • Olivier Chosidow
    • 3
    • 4
    • 5
  • Christian Brun-Buisson
    • 1
    • 2
  • Roland Amathieu
    • 6
  • Henri Mondor Hospital Necrotizing Fasciitis Group
    • 7
  1. 1.Assistance Publique-Hôpitaux de ParisHôpitaux Universitaires Henri Mondor, DHU A-TVB Service de Réanimation MédicaleCréteilFrance
  2. 2.Faculté de Médecine de Créteil, CARMAS Research GroupUPEC-Université Paris-Est Créteil Val de MarneCréteilFrance
  3. 3.Département de Dermatologie, Assistance Publique-Hôpitaux de ParisHôpitaux Universitaires Henri MondorCréteilFrance
  4. 4.INSERMCentre D’Investigation Clinique 1430CréteilFrance
  5. 5.EA EpidermEUniversité Paris-Est CréteilCréteilFrance
  6. 6.Assistance Publique-Hôpitaux de ParisHôpitaux Universitaires Henri Mondor, Service D’Anesthésie et des Réanimations ChirurgicalesCréteilFrance
  7. 7.Henri Mondor Hospital Necrotizing Fasciitis GroupHôpitaux Universitaires Henri MondorCréteilFrance

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