Osteomyelitis Complicating Sacral Pressure Ulcers: Whether or Not to Treat With Antibiotic Therapy

Wong, Darren; Holtom, Paul; Spellberg, Brad

doi:10.1093/cid/ciy559

Cited by 56 publications

(49 citation statements)

References 25 publications

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“…The consequences of HAPI range from skin redness to full skin and tissue loss, exposing tendons and bones . If a person's injury advances, they face the prospect of osteomyelitis and sepsis . Issues such as pain, immobility, lack of independence, wound exudate, and odour impact patient's self‐image and emotional state, influence a person's quality of life …”

Section: Introductionmentioning

confidence: 99%

Pressure injury data in Australian acute care settings: A comparison of three data sets

Team

Tuck

Reeves

et al. 2020

International Wound Journal

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Hospital‐acquired pressure injuries (HAPIs) represent a serious clinical and economic problem. The cost of treating HAPIs in Australian public hospitals was recently reported at AUS$983 million per annum. There are three main sources of data for documenting pressure injury (PI) occurrence in Australian hospitals: incident reporting, medical record coded data, and real‐time surveys of pressure injury. PI data reported at hospital level and to external agencies using these three different sources are variable. This reporting issue leads to inaccurate data interpretation and hinders improvement in accuracy of PI identification and PI prevention. This study involved a comparison of the three different data sources in selected Australian hospitals, to improve the accuracy and comparability of data. Findings from this study provide benchmark areas for improvement in PI documenting and reporting. Better understanding the agreement between the three data sets could lead to a more efficient and effective sharing of data sources.

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Section: Introductionmentioning

confidence: 99%

Pressure injury data in Australian acute care settings: A comparison of three data sets

Team

Tuck

Reeves

et al. 2020

International Wound Journal

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“…Coronary artery bypass surgery complicated by deep sternal wound infection frequently involves osteomyelitis of the sternal bone [ 22 ]. Elderly and paraplegic patients are at higher risk of developing deep tissue pressure injuries (i.e., pressure ulcers) that are frequently complicated by osteomyelitis [ 23 , 24 ]. As confirmed by our findings of the limited inhibition effect of 1MIC antibiotic levels, the efficacy of the traditional intravenous and oral antibiotic administration is often limited in these conditions due to the relatively low antibiotic concentrations that can be attained at the infection site.…”

Section: Discussionmentioning

confidence: 99%

In-vitro model for bacterial growth inhibition of compartmentalized infection treated by an ultra-high concentration of antibiotics

Topaz

Athamna

Ashkenazi³

et al. 2021

PLoS ONE

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Background Pseudomonas aeruginosa (P. aeruginosa), Escherichia coli (E. coli), and Staphylococcus aureus (S. aureus) are common pathogens encountered in infected cardiovascular-implantable electronic device (CIED). Continuous, in-situ targeted, ultra-high concentration antibiotic (CITA) treatment is a novel antibiotic treatment approach for localized infections. CITA provides sufficient local antibiotic concentrations to heavily infected cavities while avoiding systemic toxicity. Aim In-vitro confirmation of the efficacy of the CITA treatment approach in simulated compartmentalized infections. Materials and methods A rapid automated bacterial culture analyzing system) Uro4 HB&L™ (was applied to compare the efficacy of selected antibiotics at a standard minimal inhibitory concentration (1MIC), 4MIC, and CITA at 103MIC, for growth inhibition of high bacterial loads (106 colony-forming-units/ml) of ATCC strains of P. aeruginosa, E. coli, and S. aureus. Results The addition of gentamicin and amikacin at 1MIC concentrations only temporarily inhibited the exponential growth of E. coli and P. aeruginosa. 4MIC level extended the delay of exponential bacterial growth. Increasing concentrations of vancomycin similarly temporarily delayed S. aureus growth. All tested antibiotics at CITA of 103MIC totally inhibited the exponential growth of the tested bacteria through 72 hours of exposure. (P<0.001). Conclusion In this in-vitro model, CITA at 103MIC effectively inhibited exponential bacterial growth of high loads of P. aeruginosa, E. coli, and S. aureus. This model offers preliminary laboratory support for the benefit of the in-situ antibiotic treatment, providing ultra-high concentrations directly at the compartmentalized infection site, not achievable by the conventional intravenous and oral routes.

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“…The cumulative cost for each patient is multiplied when coupled with a readmission rate of 40% per year among spinal cord injury patients [ 10 ]. Moreover, a recent review of sacral pressure ulcers concluded that there is often futility in treating with long courses of intravenous antibiotics unless debridement and wound closure are performed, casting doubt on our ability to ever cure these infections [ 11 ].…”

Section: Gun Violence Is An Infectious Diseases Issuementioning

confidence: 99%

Let’s Join the Lane: The Role of Infectious Diseases Physicians in Preventing Gun Violence

Zheng

Mushatt

2019

Open Forum Infectious Diseases

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On November 7, 2018, the National Rifle Association (NRA) issued a tweet advising “self-important anti-gun doctors to stay in their lane.” The tweet has galvanized physicians to share their experiences with gun violence through the grassroots #ThisISOurLane campaign. Infectious diseases physicians are regularly called upon to manage complications such as infected wounds and osteomyelitis in gunshot victims. Yet, Infectious Diseases as a specialty has been poorly represented in the national dialogue on gun violence. Over 80 medical societies have endorsed statements on gun violence, including the American College of Physicians (ACP) and the American College of Cardiology; the Infectious Diseases Society of America has not. We argue that gun violence does affect the Infectious Diseases community and issue a call to action to engage in the conversation, advocate for our patients, and join with other medical societies in affirming a commitment to gun violence prevention.

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Osteomyelitis Complicating Sacral Pressure Ulcers: Whether or Not to Treat With Antibiotic Therapy

Cited by 56 publications

References 25 publications

Pressure injury data in Australian acute care settings: A comparison of three data sets

Pressure injury data in Australian acute care settings: A comparison of three data sets

In-vitro model for bacterial growth inhibition of compartmentalized infection treated by an ultra-high concentration of antibiotics

Let’s Join the Lane: The Role of Infectious Diseases Physicians in Preventing Gun Violence

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