Bacteremia associated with pressure ulcers: a prospective cohort study

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Geriatrics

Background:

• Pressure ulcers are a significant concern in healthcare settings, potentially leading to severe complications.
• Bacteremia associated with pressure ulcers (BAPU) represents a serious clinical challenge with high morbidity and mortality.
• Understanding the epidemiology and risk factors for BAPU is crucial for effective patient management.

Purpose of the Study:

• To investigate the clinical and microbiological features of BAPU.
• To identify factors associated with mortality in patients with BAPU.
• To analyze trends in BAPU incidence over time.

Main Methods:

• Prospective observational cohort study conducted over a long period (1984-2015) at a teaching hospital.
• Inclusion of 56 episodes of BAPU.
• Statistical analysis to determine risk factors for mortality, including odds ratios and confidence intervals.

Main Results:

• The incidence of BAPU significantly decreased over the study period.
• Common causative microorganisms included Staphylococcus aureus, Proteus spp., and Bacteroides spp.
• Overall mortality was 41.1%, with independent risk factors being hospital-acquired bacteremia, polymicrobial bacteremia, and low serum albumin (<23 g/L).

Conclusions:

• BAPU is an infrequent but severe complication of pressure ulcers.
• The decline in BAPU incidence suggests the effectiveness of multidisciplinary teams in ulcer management.
• Prompt identification and management of risk factors are essential to reduce mortality associated with BAPU.