Several previous studies of necrotizing fasciitis (NF) have been single-institution investigations suffering from small samples sizes. This study of 216 NF patients hospitalized in Florida, USA, during 2001 was designed to identify risk factors for length of stay (LOS), total patient charges (TC), and mortality, using a statewide database. Robust gamma mixed regression was used to determine the predictors of LOS and TC while simultaneously accounting for outliers and the clustering of patients in 87 hospitals. Relative risks (RR) for hospital mortality were calculated using binomial regression. The NF hospitalization rate in Florida was 1·3/100 000. The median TC was US$54 533 and cumulative charges for all 216 patients were nearly US$20 million. Patients aged ⩾44 years at the time of admission were five times as likely to expire in the hospital than patients who were aged ⩽43 years (adjusted RR 5·08, P=0·03). Unexpectedly, diabetes was associated with a 61% reduction in the risk of hospital mortality (adjusted RR 0·39, P=0·04). Age ⩾44 years was the most powerful predictor of prolonged LOS, elevated TC, and an increased risk of hospital mortality in patients suffering from NF.

This study examined the geographical distribution and diversity of the intrinsic OXA-51-like class D carbapenemases among Acinetobacter baumannii clones recovered in three major Greek regions from 2000 to 2005. The blaOXA-66 allele was exclusively detected among clonally distinct A. baumannii isolates recovered in the regions of Thessaloniki and Larissa. This sequence was also the most widespread among A. baumannii isolates in Athens, while less frequent were blaOXA-69 and blaOXA-65 alleles. These findings highlight the high prevalence of a specific blaOXA-51-like allele in Greece, possibly indicating that our A. baumannii clones might have originated from a common ancestor. However, the possibility that blaOXA-51-like variants, with blaOXA-66 predominating, are widely disseminated among several unrelated A. baumannii strains cannot be excluded.