Infected pressure sores: comparison of methods for bacterial identification.

Diagnosis of the bacterial component of pressure sores is notoriously difficult. We comparatively studied three methods of specimen collection from 72 pressure sores. Specimens taken by swab or by needle aspiration were compared with deep biopsy specimens as to diagnostic reliability. We found that swab specimens reflected surface colonization and that needle aspiration seemed to underestimate bacterial isolates as compared with deep tissue biopsy specimens. We recommend that antibiotics not be routinely used for treatment of colonization in pressure sores; in patients with sepsis, deep biopsy specimens can accurately diagnose infection.