Quantitative microbiology of pressure sores in different stages of healing

Sapico, Francisco L.; Ginunas, V J; Thornhill-Joynes, Monica; Canawati, Hanna N.; Capen, Daniel A.; Klein, Neil E.; Khawam, Sameyah; Montgomerie, John Z.

doi:10.1016/0732-8893(86)90089-1

Cited by 110 publications

(79 citation statements)

References 8 publications

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“…12 Most of the Gram-negative rods implicated in infection of the pressure ulcers were E.coli and P. mirabilis as was found in other studies. 10,13 This may be explained by the fact that the infection starts probably by colonisation of frail skin with bacteria from the urogenital and digestive tracts. 7 In both surgical samples and drainage liquids, bacterial species that are naturally multidrug-resistant to different antibiotics, such as P. aeruginosa, Stenotrophomonas maltophilia or Acinetobacter baumannii, were quite rarely isolated in our study (10% of the surgical samples and 13% of drainage liquids, respectively), although these species have been reported to be frequently isolated in SCI patients.…”

Section: Discussionmentioning

confidence: 99%

Bacteriological investigation of infected pressure ulcers in spinal cord-injured patients and impact on antibiotic therapy

Heym

Rimareix²,

Lortat-Jacob³

et al. 2004

Spinal Cord

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Study design: Retrospective. Objectives: To improve the use of bacteriological results for treating spinal cord-injured patients with infected pressure ulcers. Setting: Microbiology and Orthopaedics Department, Ambroise Pare´University Hospital, Boulogne-Billancourt, France. Methods: Tissue specimens, sampled at the end of the surgical intervention from unbridled and cleaned ulcers were analysed. Drainage liquids were cultured at day 1 (D1) and day 5 (D5) postsurgery. For part of the patients, a presurgery superficial sample was analysed and compared with the surgical and postsurgical samples. Results: In all, 168 surgical samples from 101 patients, 183 D1 and 104 D5 wound drainage liquids were included in this study. Out of the 168 surgical samples 17 (10%) had a negative culture, whereas 151 (90%) had a positive culture. For drainage liquids, the culture was negative in 48% and 56% of the samples at D1 and D5, respectively. The most frequently isolated species were enterobacteria, followed by staphylococci and streptococci. Conclusion: Culturing deep tissue specimens sampled from the surgically cleaned and unbridled ulcers allows for the isolation of the bacterial species that are really involved in the ulcer infection. As the identification of these bacteria and their antibiotic susceptibility are available, when the culture results of the D1 postsurgical drainage liquid is also available, it is easier to choose targeted antibiotic treatment.

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Section: Discussionmentioning

confidence: 99%

Bacteriological investigation of infected pressure ulcers in spinal cord-injured patients and impact on antibiotic therapy

Heym

Rimareix²,

Lortat-Jacob³

et al. 2004

Spinal Cord

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“…In another study, no relationship was shown between the density of microorganisms in deep tissue and the eventual outcome of myocutaneous rotation flap surgery in pressure sores (213), and Hansson (98) concluded that the number of microorganisms or number of species present in 58 non-clinically infected leg ulcers had no effect on wound healing.…”

Section: Significance Of Microorganisms In Woundsmentioning

confidence: 99%

“…In an evaluation of the microbial distribution in tissue taken from seven decubitus ulcers, Schneider et al (215) concluded that on the basis of the variability of counts obtained from a single tissue biopsy specimen, a bacterial count at a single location has limited value in determining the optimal time required to perform a wound closure. Similarly, Sapico et al (213) reported only a 63% concordance between quantitative results from biopsy specimens taken from the periphery and center of 25 pressure sores. Quantitative microbiology clearly has a valid role to play in wound management since numerous studies have shown that it can reliably predict the risk of infection and the probability of wound healing.…”

Section: Significance Of Microorganisms In Woundsmentioning

confidence: 99%

Wound Microbiology and Associated Approaches to Wound Management

2001

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The majority of dermal wounds are colonized with aerobic and anaerobic microorganisms that originate predominantly from mucosal surfaces such as those of the oral cavity and gut. The role and significance of microorganisms in wound healing has been debated for many years. While some experts consider the microbial density to be critical in predicting wound healing and infection, others consider the types of microorganisms to be of greater importance. However, these and other factors such as microbial synergy, the host immune response, and the quality of tissue must be considered collectively in assessing the probability of infection. Debate also exists regarding the value of wound sampling, the types of wounds that should be sampled, and the sampling technique required to generate the most meaningful data. In the laboratory, consideration must be given to the relevance of culturing polymicrobial specimens, the value in identifying one or more microorganisms, and the microorganisms that should be assayed for antibiotic susceptibility. Although appropriate systemic antibiotics are essential for the treatment of deteriorating, clinically infected wounds, debate exists regarding the relevance and use of antibiotics (systemic or topical) and antiseptics (topical) in the treatment of nonhealing wounds that have no clinical signs of infection. In providing a detailed analysis of wound microbiology, together with current opinion and controversies regarding wound assessment and treatment, this review has attempted to capture and address microbiological aspects that are critical to the successful management of microorganisms in wounds

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“…Por un lado, los estudios que destacan que los aspirados subestiman las bacterias aisladas 9,12,[18][19][20] , los que opinan que la torunda mayoritariamente refleja colonización 9,21,22 , y los que preconizan que la torunda cuantitativa/semicuantitativa es una alternativa razonable en determinadas ocasiones a la biopsia (patrón de referencia) 16,17,[23][24][25][26][27] . Desde el punto de vista microbiológico, pensamos que hay tres aspectos que considerar.…”

Section: Análisis Microbiológicounclassified