Fournier Gangrene in a Tertiary Surgical Center: Patterns of Microbiology, Antibiotic Resistance, and Risk Stratification

BACKGROUND: Fournier gangrene is a rapidly progressive and life-threatening soft-tissue infection originating in the perineal and genital regions, spreading quickly along fascial planes. Early identification of causative pathogens and their antimicrobial susceptibility is essential to guide empirical therapy and improve outcomes. METHODS: This retrospective study was conducted at a tertiary academic medical center. Among 59 surgically treated patients, 30 with complete clinical and microbiological data and available wound cultures were included. Demographic characteristics, microbiological profiles, and antimicrobial susceptibility patterns were analyzed. RESULTS: (9.4%), while anaerobes were rarely isolated. Resistance rates were 41.4% among Gram-positives and 38.3% among Gram-negatives. Amikacin (100%) and carbapenems (>80%) showed the highest susceptibility, whereas fluoroquinolones and aminopenicillins exhibited resistance exceeding 40%. CONCLUSION: was the predominant organism in Fournier gangrene, accompanied by substantial resistance to commonly used antibiotics. Aminoglycosides and carbapenems remain the most reliable empirical choices. Although most patients presented with low FGSI scores, the presence of resistant isolates highlights the need for region-specific antibiotic stewardship and ongoing surveillance.