Bacteriology of pressure ulcers in individuals with spinal cord injury: What we know and what we should know

Abstract

Individuals with spinal cord injury (SCI) are at increased risk for the development of pressure ulcers. These chronic wounds are debilitating and contribute to prolonged hospitalization and worse medical outcome. However, the species of bacteria and the role that specific species may play in delaying the healing of chronic pressure ulcers in the SCI population has not been well characterized. This study will review the literature regarding what is known currently about the bacteriology of pressure ulcers in individuals with SCI. An electronic literature search of MEDLINE (1966 to February 2014) was performed. Eleven studies detailing bacterial cultures of pressure ulcers in the SCI population met inclusion criteria and were selected for review. Among these studies, bacterial cultures were often polymicrobial with both aerobic and anaerobic bacteria identified with culture techniques that varied significantly. The most common organisms identified in pressure ulcers were Staphylococcus aureus, Proteus mirabilis, Pseudomonas aeruginosa, and Enterococcus faecalis. In general, wounds were poorly characterized with minimal to no physical description and/or location provided. Our present understanding of factors that may alter the microbiome of pressure ulcers in individuals with SCI is quite rudimentary, at best. Well-designed studies are needed to assess appropriate wound culture technique, the impact of bacterial composition on wound healing, development of infection, and the optimum medical and surgical approaches to wound care.

Peroxy Pyruvic Acid-Containing Topical Anti-Infective: A Potential Candidate for a Wound Instillation Solution

“…16 In a recent review article, Dana and Bauman stated that the most common organisms found in pressure ulcers are S. aureus, Proteus mirabilis, P. aeruginosa, and E. faecalis. 17 With the exception of E. coli, all of the microbes isolated in the reviewed wound studies, excluding E. coli, were also found within the foam dressing extracts in this study. The most commonly identified microbes in these wounds were Staphylococcus (27), Corynebacterium (7), Enterococcus (7), Pseudomonas (5) Streptococcus (3), and Klebsiella.…”

Septic arthritis in immunocompetent and immunosuppressed hosts

“…Other gram-negative organisms and anaerobic bacteria can cause polymicrobial septic arthritis complicating soft tissue infections, most commonly in neuropathic individuals with pressure ulcers, due to spinal cord injury [51]. Patients with ischemic limbs or chronic ulcers due to chronic venous insufficiency or arterial insufficiency may also have polymicrobial septic arthritis of the ankle or knee caused by gram-negative and anaerobic organisms in addition to staphylococci and streptococci [52].…”

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

“…W przeglądzie Dana i Bauman obejmującym dane pochodzące z badań przeprowadzonych wśród pacjentów po urazie rdzenia kręgowego od 1966 do 2014 roku zidentyfikowano 52 gatunki bakterii, z czego ponad połowę stanowiły bakterie beztlenowe [16].…”

“…Ogólnie najczęściej identyfikowanymi mikroorganizmami są: Staphylococcus aureus, Staphylococcus epidermidis, Proteus mirabilis, Pseudomonas aeruginosa oraz Escherichia coli, Acinetobacter, Providencia, Klebsiella [16]. W sytuacji gdy doszło do przerwania ciągłości skóry, przewlekłe rany mogą być kolonizowane przez bakterie pochodzące ze środowiska zewnętrznego, przylegających fragmentów skóry, przewodu pokarmowego i błony śluzowej układu moczowo-płciowego [16].…”

“…Na skutek wymienionych zmian odleżyny mogą być źródłem zakażeń tkanek miękkich i kości. Powodują wówczas zapalenia tkanki łącznej, ropnie, zapalenia kaletek maziowych, zapalenia szpiku i kości leżących w sąsiedztwie rany oraz groźną dla życia pacjenta bakteriemię [16].…”