Bacteriology and Antimicrobial Sensitivity of Isolated Bacteria from Pressure Ulcers After Spinal Cord Injury

Abstract

Background: Infection is a common problem in chronically denuded skin, especially in pressure ulcers (PUs). It is one of the main reasons for delayed wound healing, in addition to morbidity and even mortality after spinal cord injury (SCI). Objectives: The current study aimed at determining the pathogenic microorganisms, as well as their antimicrobial sensitivity, isolated from active PUs in post-rehabilitated cases with SCI. Methods: The current cross sectional study was conducted from January 2015 to January 2016, on 55 outpatients with traumatic SCI and active stage II, III, and IV PUs in the Brain and Spinal Cord Injury Research Center (BASIR), Tehran, Iran. The largest PU in each case was rinsed with sterile saline and deeply sampled with sterile swabs. The cultures were bacteriologically identified and antibiogram was performed. Results: The current study population included 55 cases with a mean age of 32.7 ± 11.5 years, of which 87.3% were male. The sacral region was the most common site (n = 31; 56.4%) for PU, followed by trochanteric area (n = 9; 16.4%). The wound swab culture was positive in 51 patients (92.7%). Majority of the bacteria isolated from smaller lesions of stage II and III PUs was Escherichia coli (E. coli) (P = 0.027), while larger lesions with advanced stage were more commonly colonized with Staphylococcus epidermidis (P = 0.0378). Antimicrobial assessment of the isolated microorganisms revealed multidrug resistant E. coli and staphylococci as the prevailing organisms. Conclusions: Microorganisms invade PUs are multi-drug resistant, and their anti-microbial sensitivity patterns may be quite different from that of normal flora.