Pressure ulcer as a reservoir of multiresistant Gram-negative bacilli: risk factors for colonization and development of bacteremia
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 prospectiv...
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| Format: | Article |
| Language: | English |
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Elsevier
2017-03-01
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| Series: | Brazilian Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1413867016305876 |
| _version_ | 1818174577448058880 |
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| author | Iolanda A. Braga Cristiane S. Brito Augusto Diogo Filho Paulo P. Gontijo Filho Rosineide M. Ribas |
| author_facet | Iolanda A. Braga Cristiane S. Brito Augusto Diogo Filho Paulo P. Gontijo Filho Rosineide M. Ribas |
| author_sort | Iolanda A. Braga |
| collection | DOAJ |
| description | 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. Keywords: Pressure ulcer, Gram-negative bacilli, Colonization, Bacteremia |
| first_indexed | 2024-12-11T19:46:37Z |
| format | Article |
| id | doaj.art-cd94943061424297b07d23ff83039adb |
| institution | Directory Open Access Journal |
| issn | 1413-8670 |
| language | English |
| last_indexed | 2024-12-11T19:46:37Z |
| publishDate | 2017-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-cd94943061424297b07d23ff83039adb2022-12-22T00:52:53ZengElsevierBrazilian Journal of Infectious Diseases1413-86702017-03-01212171175S1413-86702017000200171Pressure ulcer as a reservoir of multiresistant Gram-negative bacilli: risk factors for colonization and development of bacteremiaIolanda A. Braga0Cristiane S. Brito1Augusto Diogo Filho2Paulo P. Gontijo Filho3Rosineide M. Ribas4Universidade Federal de Uberlândia, Hospital de Clínicas, Uberlândia, MG, BrazilUniversidade Federal de Uberlândia, Instituto de Ciências Biomédicas, Uberlândia, MG, Brazil; Corresponding author.Universidade Federal de Uberlândia, Hospital de Clínicas, Uberlândia, MG, BrazilUniversidade Federal de Uberlândia, Instituto de Ciências Biomédicas, Uberlândia, MG, BrazilUniversidade Federal de Uberlândia, Instituto de Ciências Biomédicas, Uberlândia, MG, BrazilThe 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. Keywords: Pressure ulcer, Gram-negative bacilli, Colonization, Bacteremiahttp://www.sciencedirect.com/science/article/pii/S1413867016305876 |
| spellingShingle | Iolanda A. Braga Cristiane S. Brito Augusto Diogo Filho Paulo P. Gontijo Filho Rosineide M. Ribas Pressure ulcer as a reservoir of multiresistant Gram-negative bacilli: risk factors for colonization and development of bacteremia Brazilian Journal of Infectious Diseases |
| title | Pressure ulcer as a reservoir of multiresistant Gram-negative bacilli: risk factors for colonization and development of bacteremia |
| title_full | Pressure ulcer as a reservoir of multiresistant Gram-negative bacilli: risk factors for colonization and development of bacteremia |
| title_fullStr | Pressure ulcer as a reservoir of multiresistant Gram-negative bacilli: risk factors for colonization and development of bacteremia |
| title_full_unstemmed | Pressure ulcer as a reservoir of multiresistant Gram-negative bacilli: risk factors for colonization and development of bacteremia |
| title_short | Pressure ulcer as a reservoir of multiresistant Gram-negative bacilli: risk factors for colonization and development of bacteremia |
| title_sort | pressure ulcer as a reservoir of multiresistant gram negative bacilli risk factors for colonization and development of bacteremia |
| url | http://www.sciencedirect.com/science/article/pii/S1413867016305876 |
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