Abstract

VILLALOBOS-CAMACHO, Karla et al. Análisis microbiológico de úlceras de presión en pacientes del Centro Nacional de Rehabilitación (CENARE). Acta méd. costarric [online]. 2001, vol.43, n.2, pp.64-69. ISSN 0001-6002.

Background and aim: The pressure sores are areas of necrotic tissue that develop when soft tissues are compressed between a bone and an external surface. Bacterial infections are the main complication of the pressure sores. The aim of this study was to perform a microbiological analysis of pressure sores in order to determine the bacterial aerobic flora in patients admitted to the units of Medullary Injuries, Neurotrauma and General Fisiatry of the National Center of Rehabilitation and the antimicrobial susceptibility profiles of the isolates. Methods: 50 samples collected from 35 pressure sores in 22 patients, during the period from August 1998 to March 1999, were included in this study. Samples were cultured in conventional media for the isolation of aerobic bacteria. Identification of isolates were performed by standard biochemical tests and Vitek® system. Susceptibility tests were carried out by disk diffusion test and the Vitek® system. Results: P. aeruginosa, coagulase-negative Staphylococcus, S. intermedius and A. baumannii were the most frequently isolated aerobic bacterial species, which showed resistance against several antibiotics. No methicillin-resistant Staphylococcus aureus was found. Several isolates of P. aeruginosa were isolated from different sores in a single patient. These isolates showed variability in the resistance patterns during the hospitalization, suggesting acquisition of resistance genes and reinfection with phenotypically distinguishable strains. The observed resistance patterns suggest a putative intrahospitalary transmission of P. aeruginosa, coagulase-negative Staphylococcus and S. intermedius. Conclusions: Multiresistant P. aeruginosa, coagulase-negative Staphylococcus, S. intermedius and A. baumannii are the main bacterial components of the biota in the ulcer sores in patients of CENARE. Phenotypic traits suggest intrahospitalary dissemination of these bacteria among patients and institutional measures should be implemented to control such dissemination and to improve the use of antimicrobials against multiresistant bacteria.

Keywords : úlceras de presión; resistencia a antibióticos; infecciones intrahospitalarias; Acinetobacter; Pseudomonas; Staphylococcus; Enterobacteriaceae.