Detected Frequency of Bacteremia in Decubitus Ulcer Wounds and Factors Affecting Decisions to Treat

Abstract

Aim: Decubitus 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 decubitus 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 decubitus ulcer origin as an indicator in decisions to start systemic antibiotics in patients with decubitus 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 decubitus ulcer. All decubitus 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 decubitus ulcer infections at 115 different sites of the body. Result: The rate of bacteremia in decubitus 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 decubitus ulcers, 49 (42.6%), 60 (52.4%) and 6 (5.2%) were evaluated as stage 4, 3 and 2 decubitus ulcers, respectively. Conclusion: The causative agent of decubitus infections was found to be the agent causing bacteremia in 13.9% of the patients with decubitus 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 decubitus ulcer infections.