CONCLUSION:
Decubitus ulcers are a significant cause of mortality in long-term
bedridden patients, with the most common causative agents being gram
negative enteric bacteria, staphylococcus aureus, pseudomonas aeruginosa
and acinetobacter baumannii. The recommended criteria for the start of
treatment in such patients is the presence of systemic signs or positive
blood cultures. The causative agent of decubitus infections was found to
be the agent causing bacteremia in 13.9% of the patients with decubitus
ulcers in the present study.
The agent growing in the wound culture was rarely found to be the
causative agent of bacteremia when deciding whether to treat decubitus
ulcer infections. Accordingly, we recommend that the identification of
the agent causing the decubitus ulcer infection through a swab culture
alone should not be a determinant.
REFERENCES
1. Şahin, S. and F. Akçiçek, Yaşlı hastada bası yaraları önleme, tanı ve
tedavisi. Akademik Geriatri Dergisi, 2009: p. 1308-5115.
2. ALTUNEL, C.T. and S.P. KARTAL, Dekübit ve Bası Ülserleri. Turkiye
Klinikleri Geriatrics-Special Topics, 2019. 5(1): p. 87-94.
3. Braga, I., et al., Bacterial colonization of pressure ulcers:
assessment of risk for bloodstream infection and impact on patient
outcomes. Journal of Hospital Infection, 2013. 83(4): p. 314-320.
4. Dündar, D., S.K. ÖZCAN, and E. Atmaca, Evde bakım hizmeti verilen
hastaların bası yaralarındaki yüzeyel kolonizasyonun mikrobiyolojik
incelenmesi. Kocatepe Tıp Dergisi, 2012. 13(1): p. 1-6.
5. George-Saintilus, E., et al., Pressure ulcer PUSH score and
traditional nursing assessment in nursing home residents: do they
correlate? Journal of the American Medical Directors Association, 2009.
10(2): p. 141-144.
6. Bryan, C.S., C.E. Dew, and K.L. Reynolds, Bacteremia Associated With
Decubitus Ulcers. Archives of Internal Medicine, 1983. 143(11): p.
2093-2095.
7. Galpin, J.E., et al., Sepsis associated with decubitus ulcers. Am J
Med, 1976. 61(3): p. 346-50.
8. Espejo, E., et al., Bacteremia associated with pressure ulcers: a
prospective cohort study. Eur J Clin Microbiol Infect Dis, 2018. 37(5):
p. 969-975.
9. Dolynchuk, K., et al., Best practices for the prevention and
treatment of pressure ulcers. Ostomy Wound Management, 2000. 46(11): p.
38-52.
10. Haesler, E., National pressure ulcer advisory panel, european
pressure ulcer advisory panel and pan pacific pressure injury alliance.
Prevention and treatment of pressure ulcers: quick reference guide,
2014: p. 14-32.
11. Livesley, N.J. and A.W. Chow, Infected pressure ulcers in elderly
individuals. Clinical infectious diseases, 2002: p. 1390-1396.
12. Robson, M.C., et al., Maintenance of wound bacterial balance. The
American journal of surgery, 1999. 178(5): p. 399-402.
13. Drinka, P., P. Bonham, and C.J. Crnich, Swab culture of purulent
skin infection to detect infection or colonization with
antibiotic-resistant bacteria. J Am Med Dir Assoc, 2012. 13(1): p. 75-9.
14. Bluestein, D. and A. Javaheri, Pressure ulcers: prevention,
evaluation, and management. American family physician, 2008. 78(10): p.
1186-1194.
15. Demirel, M., C. Özerk Demiralp, and E. Yormuk, 2000-2005 yılları
arası bası yaraları: klinik deneyimler. 2007.
16. Peromet, M., et al., Anaerobic bacteria isolated from decubitus
ulcers. Infection, 1973. 1(4): p. 205-207.
17. Dana, A.N. and W.A. Bauman, Bacteriology of pressure ulcers in
individuals with spinal cord injury: What we know and what we should
know. J Spinal Cord Med, 2015. 38(2): p. 147-60.
18. TURAN, D.B., Etken Olduğu Bakteriyemiler İçin Risk Faktörlerinin
Değerlendirilmesi.
Table 1. Distribution of the Diagnosis of the Patients and Laboratory
Findings