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Guidelines for Point-of-Care Fluorescence Imaging for Detection of Wound Bacterial Burden Based on Delphi Consensus
Article

Are Semi-Quantitative Clinical Cultures Inadequate? Comparison to Quantitative Analysis of 1053 Bacterial Isolates from 350 Wounds

1
SerenaGroup Research Foundation, Cambridge, MA 02140, USA
2
Phil Bowler Consulting Ltd., Warrington WA1 1RG, UK
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Department of Obstetrics and Gynecology, University of Florida, Gainesville, FL 32610, USA
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MolecuLight Inc., Toronto, ON M5G 1T6, Canada
*
Author to whom correspondence should be addressed.
Academic Editor: Andreas Kjaer
Diagnostics 2021, 11(7), 1239; https://doi.org/10.3390/diagnostics11071239
Received: 17 June 2021 / Revised: 2 July 2021 / Accepted: 5 July 2021 / Published: 12 July 2021
(This article belongs to the Special Issue The Rise of Diagnostics in the Treatment of Chronic Wounds)
Early awareness and management of bacterial burden and biofilm is essential to wound healing. Semi-quantitative analysis of swab or biopsy samples is a relatively simple method for measuring wound microbial load. The accuracy of semi-quantitative culture analysis was compared to ‘gold standard’ quantitative culture analysis using 428 tissue biopsies from 350 chronic wounds. Semi-quantitative results, obtained by serial dilution of biopsy homogenates streaked onto culture plates divided into 4 quadrants representing occasional, light, moderate, and heavy growth, were compared to total bacterial load quantified as colony-forming units per gram (CFU/g). Light growth, typically considered an insignificant finding, averaged a clinically significant 2.5 × 105 CFU/g (SE = 6.3 × 104 CFU/g). Occasional growth (range: 102–106 CFU/g) and light growth (103–107 CFU/g) corresponded to quantitative values that spanned a 5-log range; moderate and heavy growth corresponded to a range of 4-log and 6-log, respectively, with a high degree of overlap in range of CFU/g per category. Since tissue biopsy and quantitative culture cannot be widely practiced and semi-quantitative analysis is unreliable, other clinically relevant approaches are required to determine wound bioburden and guide best management practices. Fluorescence imaging is a point-of-care technology that offers great potential in this field. View Full-Text
Keywords: semi-quantitative culture; quantitative culture; wound biopsy; chronic wounds; wound microbiology; fluorescence imaging semi-quantitative culture; quantitative culture; wound biopsy; chronic wounds; wound microbiology; fluorescence imaging
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MDPI and ACS Style

Serena, T.E.; Bowler, P.G.; Schultz, G.S.; D’souza, A.; Rennie, M.Y. Are Semi-Quantitative Clinical Cultures Inadequate? Comparison to Quantitative Analysis of 1053 Bacterial Isolates from 350 Wounds. Diagnostics 2021, 11, 1239. https://doi.org/10.3390/diagnostics11071239

AMA Style

Serena TE, Bowler PG, Schultz GS, D’souza A, Rennie MY. Are Semi-Quantitative Clinical Cultures Inadequate? Comparison to Quantitative Analysis of 1053 Bacterial Isolates from 350 Wounds. Diagnostics. 2021; 11(7):1239. https://doi.org/10.3390/diagnostics11071239

Chicago/Turabian Style

Serena, Thomas E., Philip G. Bowler, Gregory S. Schultz, Anna D’souza, and Monique Y. Rennie. 2021. "Are Semi-Quantitative Clinical Cultures Inadequate? Comparison to Quantitative Analysis of 1053 Bacterial Isolates from 350 Wounds" Diagnostics 11, no. 7: 1239. https://doi.org/10.3390/diagnostics11071239

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