Secondary Microbial Infection in Pyoderma Gangrenosum: Comparable Rates to Venous Ulcers in a Retrospective Cohort.

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis traditionally regarded as a sterile inflammatory ulcer; however, positive wound cultures are frequently encountered in clinical practice and may complicate or delay diagnosis and management. Data regarding bacterial superinfection in PG remain l...

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Publicado en:Wound Repair & Regeneration Vol. 34; no. 2; pp. 1 - 6
Autores principales: Stenger, Katelyn S., Burger, Elise S.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Mar2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2026
      vid: 34
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/wrr.70161
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        atl: Secondary Microbial Infection in Pyoderma Gangrenosum: Comparable Rates to Venous Ulcers in a Retrospective Cohort.
      aug:
        au:
          Stenger, Katelyn S.
          Burger, Elise S.
        affil: The University of Hawaii, John A. Burns School of Medicine, Honolulu Hawaii,, USA
      sug:
        subj:
          Pyoderma Gangrenosum
          Coinfection
          Venous Ulcer
          Diagnosis, Delayed
          Disease Management
          Human
          Male
          Female
          Descriptive Statistics
          Retrospective Design
          Record Review
          International Classification of Diseases
          Electronic Health Records
          Fisher's Exact Test
          Prospective Studies
          Data Analysis Software
          Body Mass Index
          Male
          Female
      ab: Pyoderma gangrenosum (PG) is a neutrophilic dermatosis traditionally regarded as a sterile inflammatory ulcer; however, positive wound cultures are frequently encountered in clinical practice and may complicate or delay diagnosis and management. Data regarding bacterial superinfection in PG remain limited. The objective of this study was to determine the frequency and spectrum of microbial involvement in PG ulcers compared with venous ulcers. We performed a retrospective cohort study of patients evaluated at the University of Utah between June 2012 and June 2025. Electronic medical records were queried using International Classification of Diseases codes to identify patients with PG or venous ulcers, with diagnosis confirmed by manual chart review. Ulcers were included if at least one bacterial wound swab or tissue culture had been obtained. Isolated organisms were recorded, and associations between ulcer type and organism isolation were analysed using Fisher's exact test. The cohort included 292 patients (143 PG, 149 venous ulcers). Secondary microbial growth occurred in 50.3% of PG ulcers and 50.3% of venous ulcers. Pseudomonas aeruginosa was isolated in 11.9% of PG ulcers and 9.4% of venous ulcers (p = 0.57). Staphylococcus species were the most frequently identified organisms in both groups. No statistically significant difference in overall culture positivity or Pseudomonas isolation was observed between ulcer types. These findings demonstrate that PG ulcers are not uniformly sterile, with approximately half demonstrating microbial superinfection. Infection rates were comparable to those observed in venous ulcers, suggesting that secondary microbial involvement is common across chronic wound types. Positive cultures should not preclude the diagnosis of PG, and recognition of superinfection may support appropriate antimicrobial use while avoiding diagnostic delay.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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