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

Abstract

Introduction: Pressure injuries 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 injury, 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 injuries. Material and method: Included in the study were all patients over the age of 18 years receiving palliative care in hospital, and with a pressure injury. Pressure injury samples of the patients were taken within the first 24 hours of admission to the hospital. All decubitus ulcers 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 ulcers. 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. 76 of 208 patients hospitalized in palliative care in 2018 had decubitus ulcers. We detected decubit ulcers infections in 75 of 76 patients. Among the 75 (65.2%) patient had pressure ulcers infections at 115 different sites of the body. Result: The rate of bacteremia in Pressure injury was 13.9% (16/115) , and the agents were found to be polymicrobial in the ulcers cultures of 42 (55.2%) of the patients. The most common accompanying bacteria were Acinetobacter, Pseudomonas aeruginosa and Escherichia coli(E.coli). Among the pressure injurys, 49 (42.6%), 60 (52.4%) and 6 (5.2%) were evaluated as stage 4, 3 and 2 pressure injurys, respectively. Conclusion:The causative agent of decubitus infections was found to be the agent causing bacteremia in 13.9% of the patients with pressure injury in the present study. The agent growing in the ulcer culture was rarely found to be the causative agent of bacteremia when deciding whether to treat pressure injury infections with systemic antibiotic.