Pathogen profile and antibiotic susceptibility in stage III-IV pressure ulcers in a tropical region of China
DOI:
https://doi.org/10.3855/jidc.22593Keywords:
Tropical region, pressure ulcer, pathogen distribution, antimicrobial susceptibility analysisAbstract
Introduction: This study aimed to investigate the distribution and antimicrobial susceptibility patterns of pathogens isolated from 244 patients with stage III and IV pressure ulcers in China’s tropical region and to provide evidence to support appropriate antimicrobial therapy in clinical practice.
Methodology: We retrospectively analyzed the clinical and microbiological data of 244 inpatients with stage III or IV pressure ulcers who were admitted to three tertiary hospitals in Hainan Province between January 2020 and December 2024. Clinical specimens were collected from all patients, yielding a total of 270 wound isolates for assessment of pathogen distribution and antimicrobial susceptibility.
Results: Gram-negative bacteria (GNB) predominated in both stage III and stage IV ulcers, accounting for 55.05% and 69.57% of isolates, respectively. Gram-positive bacteria (GPB) accounted for 40.37% and 22.36% of isolates, respectively. The three most common GNB were Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae, while Staphylococcus aureus and Enterococcus spp. were the leading GPB. Fungal isolates accounted for 4.59% of stage III samples and 8.07% of stage IV samples, with Candida tropicalis and C. albicans as the predominant species. Major GNB exhibited resistance rates below 15% to piperacillin–tazobactam, cefoperazone, and ertapenem. GPB showed high resistance to penicillin, gentamicin, and erythromycin, whereas no resistance was detected to vancomycin, teicoplanin, or linezolid. Antifungal susceptibility testing was not performed.
Conclusions: In China’s tropical region, stage III and IV pressure ulcers are mainly associated with GNB, which remain highly susceptible to piperacillin–tazobactam and cefoperazone. GPB shows high susceptibility to vancomycin, linezolid, and teicoplanin.
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Copyright (c) 2026 Linlin Wang, Gang Jing, Lei Wu, Yingying Li, Qiang Li
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