Skin Biopsy is Predictive of Outcome in Experimental Sepsis by Multidrug- Resistant Pseudomonas aeruginosa

To evaluate whether histological findings of skin in sepsis by Pseudomonas aeruginosa could be a predictive factor of progression to death, histological alterations after challenge by one multidrug-resistant isolate were studied in 24 rabbits. Acute pyelonephritis was induced after ligation of the right ureter and injection of 108 CFU per kg of body weight into the renal pelvis. Biopsy samples of skin were taken on necropsy. Mean survival of animals after bacterial challenge was 5.23 days. Main histological findings of skin were inflammation and swelling of dermis; thickening of endothelium; presence of thrombi in vessels; necrobiotic changes of the hair follicles. Serum TNFα was negatively correlated to histology of dermis and follicles. Positive correlation was found between survival and swelling of dermis. It is concluded that prolongation of survival was accompanied by intense edema of the dermis. A punch skin biopsy might be a predictive factor of sepsis outcome.