Infection is not flesh-eating, not uncommon in Augusta, experts say

Dr. Jack Austin is pretty clear about all of the interest in so-called flesh-eating bacteria sparked by the highly publicized case of a Georgia woman fighting a devastating infection at the Joseph M. Still Burn Center at Doctors Hospital.

 

“There’s no such thing as a flesh-eating bacteria,” said Austin, an infectious disease expert at University Hospital and the Walton Wound Care Center. “It’s a media-derived, made-up word.”

Austin sees one or two cases a month, usually in people with compromised immune systems.

Doctors, a regional referral center for many large wounds, saw 42 cases last year, including 33 from Georgia and seven from South Carolina, Doctors spokeswoman Barclay Bishop said.

About 8.5 percent – three or four of the wound cases – were admitted to the intensive care unit.

The invasive infection is often caused by common bacteria.

The infection is most often associated with group A streptococcus, typically found in the throat or on the skin, that causes common mild infections such as “strep throat” or an itchy skin rash, according to the Centers for Disease Control and Prevention.

But in 9,000 to 11,500 cases a year, it gets into the bloodstream, becomes invasive and causes a much more serious infection. It takes a certain set of conditions or just bad luck for it to cause necrotizing fasciitis, Austin said.

In up to 7 percent of those systemic infections, it gets into the fascia, the lining between muscle groups and organ systems,
where it can create a reservoir of infection and spread rapidly, Austin said.

It often takes surgery to stay ahead of the infection. Damage from toxins and lack of blood flow kill surrounding flesh,
attacking small blood vessels in organs such as the kidneys and in the hands and feet, said Dr. Steve Holsten, the associate professor of trauma and critical medicine at Georgia Health Sciences University.

The toxins and the body’s response can also drop blood pressure to dangerously low levels and send patients into shock, Austin and Holsten said.

About 25 percent of necrotizing fasciitis patients die, the CDC said.

While more cases are coming to light in the wake of the publicity surrounding Aimee Copeland, “there is not an epidemic” of the infections, Austin said.

They show up regularly in Augusta, not only at Doctors but also at University, he said.

“We see massive soft tissue infections all the time,” Holsten said.

“They just don’t make the press,” Austin said.

 

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Sun, 10/22/2017 - 17:59

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