P-36   EARLY CUTANEOUS ALTERATIONS IN EXPERIMENTAL SEPSIS FROM MULTIDRUG-RESISTANT PSEUDOMONAS AERUGINOSA

H. Petropoulou1, M. Mouktaroudi2, EJ Giamarellos-Bourboulis3 , I. Donta2, D. Perrea2, NG Stavrianeas1. Department of Dermatology and Venereology1, Laboratory of Experimental Surgery and Surgical Research2 and 4th Department of Internal Medicine, University of Athens3, Greece.

Purpose: The virulence of nosocomial isolates in the evolution to sepsis is yet undefined. Cutaneous alterations occurring in the field of sepsis involving the vasculature signify haemodynamic derangement. The present study investigated the extension of the early alterations of peripheral blood vessels as well as of hair follicles following exposure to multidrug - resistant P. aeruginosa. Methods: Four male rabbits were applied. Sepsis was induced by intravenous infusion of 5x108 CFU of two different isolates resistant to ceftazidime, amicacin, imipenem and ciprofloxacin from one left jugular vein catheter. Cutaneous biopsies were taken 90, 120 and 210 min after bacterial infusion from the dorsal surface of legs. A subcutaneous fat specimen was drawn at 210 min quantitative culture. Results: Epidermal alterations were not documented in any of the above intervals. At 90 min mild endothelitis with fattening and swelling of the endothelliocytes in vessels of dermis was found with perivascular invasion from neutrophils and lymphocytes and necrobiosis of hair follicles. The above observations were more prominent 210 min after the microbial administration. The quantitative culture of subcutaneous fat revealed mean 2x101 CFU/g for the first isolate and 5.5x102 CFU/g for the second isolate. Conclusions: Inflammation of peripheral vessels is documented early after inoculation, verifying the considerable virulence of the multidrug-resistant nosocomial isolates. Necrobiotic alterations as well as segregation of epithelial cells on hair follicles were also observed.