Swab cultures for pressure ulcers are:

• A. Not recommended due to polymicrobial contamination.
• B. Strongly recommended in all cases.
• C. Only recommended for stage 1 ulcers.
• D. Recommended after antibiotic therapy.

Answer: (A)

Pressure ulcers on the surface are typically heavily colonized with a mix of skin and environmental bacteria, so a swab tends to capture those surface organisms rather than the ones actually causing tissue infection. This polymicrobial contamination makes swab cultures unreliable for guiding treatment, since they can suggest organisms that aren’t driving the infection and miss those deeper in the wound. When infection is suspected, the more accurate approach is a deep tissue culture or biopsy (often after debridement) to identify the true pathogens and their antibiotic sensitivities. Cultures obtained after starting antibiotics are less informative, which further reduces the value of swab cultures in guiding therapy.