Necrotizing soft tissue infections (NSTIs) are severe clinical conditions requiring swift therapeutic intervention, including surgical removal of infected tissue and administration of potent antibiotics. There is wide diversity in the microbial etiologic agents, and tailoring the antibiotic treatment to the offending pathogen is essential. However, the choice of empirical therapy is frequently inadequate, underlining the need for comprehensive and contemporary knowledge on causative pathogens and relevant antimicrobial resistance patterns in NSTIs. Also, studies of the pathogenic mechanisms in different NSTIs are needed, to improve handling of patients through developing patient stratification and tailored therapies. We review the current knowledge on microbial etiology and provide detailed characterizations of the predominant pathogens.
Keywords: Bacteroides fragilis; Monomicrobial; Necrotizing soft tissue infection; Polymicrobial; Staphylococcus aureus; Streptococcus dysgalactiae; Streptococcus pyogenes; Type 1 infection; Type 2 infection.