Pressure ulcer as a reservoir of multiresistant Gram-negative bacilli: risk factors for colonization and development of bacteremia

Abstract

The purpose of this study was to identify the risk factors that predispose patients who are hospitalized with pressure ulcers (PUs) colonized by Gram-negative bacilli (GNB) to develop bacteremia. In addition, we also detected main phenotypes of resistance in infected and uninfected PUs. A prospective cohort study was conducted at the Clinical Hospital of the Federal University of Uberlândia including patients with Stage II or greater PUs, colonized or not with GNB, from August 2009 to July 2010. Infected ulcers were defined based on clinical signs and on positive evaluation of smears of wound material translated by a ratio of polymorphonuclear cells to epithelial cells ≥2:1, after Giemsa staining. A total of 60 patients with Stage II PUs were included. Of these 83.3% had PUs colonized and/or infected. The frequency of polymicrobial colonization was 74%. Enterobacteriaceae and GNB non-fermenting bacteria were the most frequent isolates of PUs with 44.0% of multiresistant isolates. Among patients who had infected PUs, six developed bacteremia by the same microorganism with a 100% mortality rate. In addition, PUs in hospitalized patients were major reservoir of multiresistant GNB, also a high-risk population for the development of bacteremia with high mortality rates.

Transmission of resistant Gram-negative bacteria to healthcare personnel gowns and gloves during care of residents in community-based nursing facilities

“…Seven percent of the isolates were resistant to fluoroquinolones, 76% were resistant to cephalosporins, 14% were resistant to carbapenems and 40% were multi-drug resistant. 16 Furthermore, the presence of pressure ulcers has been described as a risk factor associated with RGNB colonization. 18 Given this and the high dependency of those with pressure ulcers on HCP for care, it is not surprising that interacting with a resident with a pressure ulcer was associated with a higher transmission risk of RGNB.…”

Importance of physiotherapy in prevention and treatment of pressure sores in post-stroke patients

“…methicyllin-resistant Staphylococcus aureus). Odleżyny stają się wówczas rezerwuarem drobnoustrojów i źródłem zakażenia krwi, powodując bakteriemię, co przyczynia się do zwiększenia śmiertelności wśród hospitalizowanych pacjentów [17]. W większości przewlekłych ran zawierających więcej niż jeden gatunek bakterii wytwarza się efekt synergiczny, który powoduje, że wcześniej niewirulentny gatunek bakterii staje się coraz bardziej zjadliwy, powodując uszkodzenie tkanek gospodarza.…”

Calcination Temperatures, Compositions and Antimicrobial Properties of Heterostructural ZnO–CuO Nanocomposites from Calotropis Gigantea Targeted for Skin Ulcer Pathogens

“…; followed by Staphylococcus aureus (S. aureus) (28.0%) and non-fermenting GNB (23.0%), mostly Pseudomonas aeruginosa (P. aeruginosa), Acinetobacter spp. and Methicillin-resistant S. aureus (MRSA) [4,5,6,7]. PUs are open infected wounds that develop on the skin as result of pressure on one spot of the body for too long or from friction on the skin.…”

“…These pathogens are commonly associated with skin ulcer disease[4,5,6,7]. The MIC values of the green synthesised ZnO-400C for E. coli, P. aeruginosa, K. pneumonia and MRSA were at 0.3125, 0.15625, 0.625 and 0.15625 mg/mL, respectively.…”