Detected frequency of bacteremia in pressure ulcer and the decision to systemic antibiotic

Abstract

Introduction: Pressure ulcers are a significant cause of morbidity and mortality, and a source of considerable expense in health expenditures. Bacteremia is a frequently seen complication of pressure ulcers, although its incidence has yet to be well defined, and there are scarce studies on the subject. The aim in the present study is to assess the frequency of bacteremia of pressure ulcer origin as an indicator in decisions to start systemic antibiotics in patients with pressure ulcers. Material and metods: Included in the study were all patients over the age of 18 years receiving palliative care in hospital, and with a pressure ulcer. Pressure wound samples of the patients were taken within the first 24 hours of admission to the hospital. All pressure wounds were washed with sterile saline and a sample was taken using a sterile cotton swab from the deepest and the most solid part of the wounds. we included 76 patients whose 40 (52.6%) were male and 36 (47.4%) were female, with a mean age of 70.8±15.6 (18-95) years. Among the 76 patients, 75 (65.2%) had pressure ulcer infections at 115 different sites of the body. Result: The rate of bacteremia in pressure ulcers was 13.9% (16/115) , and the agents were found to be polymicrobial in the wound cultures of 42 (55.2%) of the patients. The most common accompanying bacteria were Acinetobacter, Pseudomonas aeruginosa and E.coli. Among the pressure ulcers, 49 (42.6%), 60 (52.4%) and 6 (5.2%) were evaluated as stage 4, 3 and 2 pressure ulcers, respectively. Conclusion: The causative agent of pressure infections was found to be the agent causing bacteremia in 13.9% of the patients with pressure ulcers in the present study. The agent growing in the wound culture was rarely found to be the causative agent of bacteremia when deciding whether to treat pressure ulcer infections

Keywords

• palliative care
• bacteremia
• pressure ulcer

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