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Prevalence of Multidrug-Resistant and ESBL-Producing Bacterial Pathogens in Patients with Chronic Wound Infections
Reem Binsuwaidan1, Mohammad Aatif Khan2, Raghad H Alzahrani3
1Department of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia.
Abstract:
A pressure ulcer is defined as a skin lesion of ischemic origin, a condition that contributes to morbidity and mortality in patients with spinal cord injuries. The most common complication of ulcers is a bacterial infection. Antimicrobial therapy should be selected with caution for spinal cord injury patients since they have a high risk of developing multidrug-resistant (MDR) infections. The aim of this study was to determine the prevalence of different bacterial pathogens in patients with pressure ulcers admitted with spinal cord injuries. This was a retrospective single-center study that included adult patients aged 18 years and above, admitted with chronic pressure wounds after a spinal cord injury requiring hospitalization between 2015 and 2021. A total of 203 spinal cord injury patients with pressure ulcers were included in the study. Ulcers were commonly infected by Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli, and they were mostly located in the sacral and gluteal areas. More than half of the bacteria isolated from patients were sensitive to commonly tested antibiotics, while 10% were either MDR- or pan-drug-resistant organisms. Of the MDR bacterial isolates, 25.61% were methicillin-resistant S. aureus, and 17.73% were extended-spectrum beta-lactamase Enterobacteriaceae. The most prevalent bacteria in pressure ulcers of spinal cord injury patients were S. aureus. Other antibiotic-resistant organisms were also isolated from the wounds.
Insights
Pressure ulcers in spinal cord injury patients are frequently infected by bacteria like Staphylococcus aureus. Caution is needed with antimicrobial therapy due to the high prevalence of multidrug-resistant organisms.
Area of Science:
- Medical Microbiology
- Clinical Medicine
- Epidemiology
Background:
- Pressure ulcers are common and serious complications in spinal cord injury (SCI) patients.
- Bacterial infections are a frequent complication of pressure ulcers, increasing morbidity and mortality.
- SCI patients are at high risk for multidrug-resistant (MDR) infections, complicating antimicrobial therapy.
Purpose of the Study:
- To determine the prevalence of bacterial pathogens in pressure ulcers among hospitalized SCI patients.
- To identify common bacterial species and their antibiotic resistance patterns in this patient population.
Main Methods:
- Retrospective, single-center study.
- Inclusion of adult SCI patients (≥18 years) with pressure ulcers hospitalized between 2015 and 2021.
- Analysis of bacterial isolates from pressure ulcers.
Main Results:
- 203 SCI patients with pressure ulcers were included.
- Commonly isolated bacteria included Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli, primarily in sacral and gluteal areas.
- 10% of isolates were multidrug-resistant (MDR) or pan-drug-resistant, including methicillin-resistant S. aureus (25.61% of MDR) and extended-spectrum beta-lactamase Enterobacteriaceae (17.73% of MDR).
Conclusions:
- Staphylococcus aureus was the most prevalent bacterium in pressure ulcers of SCI patients.
- The study highlights the significant presence of antibiotic-resistant organisms, including MDR strains, necessitating careful antimicrobial selection in SCI patients with pressure ulcers.
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