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Bacteremia associated with decubitus ulcers.

C S Bryan, C E Dew, K L Reynolds

    Archives of Internal Medicine
    |November 1, 1983
    PubMed
    Summary
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    Decubitus ulcers are a significant source of bacteremia (bacteria in the blood) in hospitalized patients. Prompt identification and treatment are crucial, as these infections are associated with high mortality rates.

    Area of Science:

    • Infectious Diseases
    • Critical Care Medicine
    • Geriatric Medicine

    Background:

    • Decubitus ulcers, also known as pressure ulcers or bedsores, are common in hospitalized patients.
    • These chronic wounds can serve as a portal of entry for microorganisms into the bloodstream, leading to bacteremia.
    • Understanding the sources and pathogens associated with bacteremia in this population is critical for effective management.

    Purpose of the Study:

    • To investigate the incidence and probable sources of bacteremia in patients with decubitus ulcers.
    • To identify the common bacterial pathogens isolated from blood cultures in these patients.
    • To determine the mortality rates and causes of death associated with bacteremia originating from decubitus ulcers.

    Main Methods:

    • Retrospective analysis of 104 episodes of bacteremia in 102 patients with decubitus ulcers over a five-year period.

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  • Identification of probable sources of bacteremia, with a focus on decubitus ulcers.
  • Analysis of blood isolates, including common bacterial species and their correlation with ulcer origin.
  • Assessment of overall mortality and attribution of deaths to infection.
  • Main Results:

    • Decubitus ulcers were identified as the probable source of bacteremia in 49% of episodes.
    • Another documented site of infection was present in 86% of patients.
    • Proteus mirabilis, Staphylococcus aureus, and Escherichia coli were the most frequent blood isolates.
    • Bacteroides species showed a significant correlation with bacteremia originating from decubitus ulcers.
    • The overall mortality rate was 55%, with 51% of deaths attributed to infection.

    Conclusions:

    • Decubitus ulcers represent a significant and often overlooked source of bacteremia in hospitalized patients.
    • Effective management of decubitus ulcers may reduce the incidence of bacteremia and associated mortality.
    • Further research into preventative strategies and targeted antimicrobial therapy for bacteremia related to decubitus ulcers is warranted.