Microbiological analysis of pressure ulcers in patients of the CENARE National Rehabilitation Center
DOI:
https://doi.org/10.51481/amc.v43i2.53Keywords:
úlceras de presión, resistencia a antibióticos, infecciones intrahospitalarias, Acinetobacter, Pseudomonas, Staphylococcus, EnterobacteriaceaeAbstract
Background and aim: The pressure sores are areas of necro-tic tissue that develop when soft tissues are compressed be tween a bone and an exte rnal surface. Bacterial infe ctions are the main compl ication of the pressure sores. The aim of this study was to perform a micr obi ological analysis of pressure sores in order to dete rmine the bacterial aerobic fl ora in patients admitted to the units of Medullary Injuries, Neurotrauma and General Fisiatry of the Nati onal Center of Rehabilitation and the antimicr obial susce ptibility profiles of the isolates.
Methods: 50 samples collected from 35 pressure sores in 22 patients, during the period from August 1998 to March 1999, were included in this study. Samples were cultured in conventional media for the isolation of aerobic bacteria. Iden-tification of isolates were performed by standard biochemical tests and Vitek® system. Susceptibility tests were carried out by disk diffusion test and the Vitek® system.
Results: P. aeruginosa, coagulase-negative Staphylococcus, S. intermedius and A. baumannii were the most frequently isolated aerobic bacterial species, which showed resistance against several antibiotics. No methicillin-resistant Staphylococcus aureus was found. Several isolates of P. aeruginosawere isolated from different sores in a single patient. These isolates showed variability in the resistance patterns during the hospitalization, suggesting acquisition of resistance genes and reinfection with phenotypically distinguishable strains. The observed resistance patterns suggest a putative intrahos-pitalary transmission of P. aeruginosa, coagulase-negative Staphylococcus and S. intermedius.
Conclusions: Multiresistant P. aeruginosa, coagulase-nega-tive Staphylococcus, S. intermedius and A. baumannii are the main bacterial components of the biota in the ulcer sores in patients of CENARE. Phenotypic traits suggest intrahos-pitalary dissemination of these bacteria among patients and institutional measures should be implemented to control such dissemination and to improve the use of antimicrobials against multiresistant bacteria.
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