scholarly journals Efficacy of a bacterial fluorescence imaging device in an outpatient wound care clinic: a pilot study

2019 ◽  
Vol 28 (7) ◽  
pp. 438-443 ◽  
Author(s):  
Ciaran M. Hurley ◽  
Pat McClusky ◽  
Ryan M. Sugrue ◽  
James A. Clover ◽  
Jason E. Kelly
Keyword(s):  
Real Time ◽  
Fluorescence Imaging ◽  
Predictive Value ◽  
Pathogenic Bacteria ◽  
Wound Care ◽  
Bacterial Species ◽  
University Hospital ◽  
Fluorescent Light ◽  
Care Clinic ◽  
Imaging Device

Objective: Subsurface bacterial burden can be missed during standard wound examination protocols. The real-time bacterial fluorescence imaging device, MolecuLight i:X, visualises the presence of potentially harmful levels of bacteria through endogenous autofluorescence, without the need for contrast agents or contact with the patient. The intended use of the imaging device is to assist with the management of patients with wounds by enabling real-time visualisation of potentially harmful bacteria. The aim of this study was to establish the accuracy of the wound imaging device at detecting pathogenic bacteria in wounds. Methods: A single-centre, prospective observational study was conducted in Cork University Hospital in an outpatient plastic surgery wound care clinic. Patients had their wounds photographed under white and autofluorescent light with the imaging device. Auto-fluorescent images were compared with the microbiological swab results. Results: A total of 33 patients and 43 swabs were included, of which 95.3% (n=41) were positive for bacteria growth. Staphylococcus aureus was the most common bacterial species identified. The imaging device had a sensitivity of 100% and specificity of 78% at identifying pathological bacteria presence in wounds on fluorescent light imaging. The positive predictive value (PPV) was 95.4%. The negative predictive value (NPV) was 100%. It demonstrated a sensitivity and specificity of 100% at detecting the presence of Pseudomonas spp. Conclusion: The imaging device used could be a safe, effective, accurate and easy-to-use autofluorescent device to improve the assessment of wounds in the outpatient clinic setting. In conjunction with best clinical practice, the device can be used to guide clinicians use of antibiotics and specialised dressings.

scholarly journals 3124 Early Electrographic Seizure Detection by Neuro ICU Nurses via Bedside Real-Time Quantitative EEG

2019 ◽  
Vol 3 (s1) ◽  
pp. 38-38
Author(s):  
Safa Kaleem ◽  
Christa B. Swisher
Keyword(s):  
Positive Predictive Value ◽  
Real Time ◽  
Predictive Value ◽  
Quantitative Eeg ◽  
University Hospital ◽  
Duke University ◽  
Study Population ◽  
Time To Detection ◽  
Sensitivity Specificity ◽  
Improve Patient

OBJECTIVES/SPECIFIC AIMS: 1. Determine positive predictive value, negative predictive value, sensitivity, and specificity of Neuro ICU nurse interpretation of real-time bedside qEEG. 2. Determine difference in time to detection of first seizure between Neuro ICU nurse qEEG interpretation and EEG fellow reads of cEEG. 3. Determine what qualities of seizures make detection by neuro ICU nurses more or less likely – e.g. duration of seizures, type of seizures, spatial extent of seizures. METHODS/STUDY POPULATION: Recruit neuro ICU nurses taking care of 150 patients admitted to the Neuro ICU at Duke University Hospital who are initiated on cEEG monitoring. Nurses will be consented for their participation in the study. Neuro ICU nurses will evaluate the qEE RESULTS/ANTICIPATED RESULTS: From literature estimates of a 20% seizure prevalence in critical care settings, we hope to have 30 patients with seizures and 120 without. Based on prior study in the Duke Neuro ICU, we hypothesize that Neuro ICU nurses will have sensitivity and DISCUSSION/SIGNIFICANCE OF IMPACT: This is the first prospective study of neuro ICU nurse interpretation of real-time bedside qEEG in patients with unknown NCSE/NCS presence. If nurse sensitivity, specificity, and positive predictive value are clinically useful, which we deem would be so at a sensitivity of 70% or greater, with acceptable false alarm rate, nurse readings of qEEG could significantly decrease the time to treatment of seizures in the Neuro ICU patient population, and perhaps could improve patient outcomes.

scholarly journals Copper-Silver Alloy Coated Door Handles as a Potential Antibacterial Strategy in Clinical Settings

Coatings ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 790
Author(s):  
Nicole Ciacotich ◽  
Lasse Kvich ◽  
Nicholas Sanford ◽  
Joseph Wolcott ◽  
Thomas Bjarnsholt ◽  
...  
Keyword(s):  
Pathogenic Bacteria ◽  
Wound Care ◽  
Care Center ◽  
Bacterial Species ◽  
Alloy Coating ◽  
Field Trials ◽  
Plate Count ◽  
Clinical Settings ◽  
Antibacterial Efficacy ◽  
Silver Alloy

Coating surfaces with a copper-silver alloy in clinical settings can be an alternative or complementary antibacterial strategy to other existing technologies and disinfection interventions. A newly developed copper-silver alloy coating has a high antibacterial efficacy against common pathogenic bacteria in laboratory setups, and the purpose of this study is to determine the antibacterial efficacy of this copper-silvery alloy in real-world clinical settings. Two field trials were carried out at a private clinic and a wound care center. Door handles coated with the copper-silver alloy had a lower total aerobic plate count (1.3 ± 0.4 Log CFU/cm2 and 0.8 ± 0.3 Log CFU/cm2, CFU stands for Colony Forming Units) than the reference uncoated material on-site (2.4 ± 0.4 Log CFU/cm2 for the stainless steel and 1.7 ± 0.4 Log CFU/cm2 for the satin brass). The copper-silver alloy did not selectively reduce specific bacterial species. This study points to the possibility of a successful long-term implementation of the copper-silver alloy coating as an antibacterial strategy.

Fluorescence imaging guided dressing change frequency during negative pressure wound therapy: a case series

2019 ◽  
Vol 28 (Sup9) ◽  
pp. S28-S37 ◽  
Author(s):  
Rose Raizman
Keyword(s):  
Real Time ◽  
Fluorescence Imaging ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Case Series ◽  
Cost Effective ◽  
Wound Therapy ◽  
Imaging Device ◽  
Treatment Regimens ◽  
Selection Of

Objective: Knowledge of wound bioburden can guide selection of therapies, for example, the use of negative pressure wound therapy (NPWT) devices with instillation in a heavily contaminated wound. Wound and periwound bacteria can be visualised in real-time using a novel, non-contact, handheld fluorescence imaging device that emits a safe violet light. This device was used to monitor bacterial burden in patients undergoing NPWT. Methods: Diverse wounds undergoing NPWT were imaged for bacterial (red or cyan) fluorescence as part of routine wound assessments. Results: We assessed 11 wounds undergoing NPWT. Bacterial fluorescence was detected under sealed, optically-transparent (routine) adhesive before dressing changes, on foam dressings, within the wound bed, and on periwound tissues. Bacterial visualisation in real-time helped to guide: (1) bioburden-based, personalised treatment regimens, (2) clinician selection of NPWT, with or without instillation of wound cleansers, and (3) the extent and location of wound cleaning during dressing changes. The ability to visualise bacteria before removal of dressings led to expedited dressing changes when heavy bioburden was detected and postponement of dressing changes for 24 hours when red fluorescence was not observed, avoiding unnecessary disturbance of the wound bed. Conclusion: Fluorescence imaging of bacteria prompted and helped guide the timing of dressing changes, the extent of wound cleaning, and selection of the appropriate and most cost-effective NPWT (standard versus instillation). These results highlight the capability of bacterial fluorescence imaging to provide invaluable real-time information on a wound's bioburden, contributing to clinician treatment decisions in cases where bacterial contamination could impede wound healing.

Use of a bacterial fluorescence imaging device: wound measurement, bacterial detection and targeted debridement

2019 ◽  
Vol 28 (12) ◽  
pp. 824-834 ◽  
Author(s):  
Rose Raizman ◽  
Danielle Dunham ◽  
Liis Lindvere-Teene ◽  
Laura M Jones ◽  
Kim Tapang ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Fluorescence Imaging ◽  
Wound Care ◽  
Standard Of Care ◽  
Imaging Device ◽  
Wound Assessment ◽  
Coefficients Of Variation ◽  
Heavy Loads ◽  
Evidenced Based ◽  
Wound Bed Preparation

Objective: Diagnostics which provide objective information to facilitate evidence-based treatment decisions could improve the chance of wound healing. Accurate wound measurements, objective bacterial assessment, and the regular, consistent tracking of these parameters are important aspects of wound care. This study aimed to assess the accuracy, clinical incorporation and documentation capabilities of a handheld bacterial fluorescence imaging device (MolecuLight i:X). Method: Benchtop wound models with known dimensions and clinical wound images were repeatedly measured by trained clinicians to quantify accuracy and intra/inter-user coefficients of variation (COV) of the imaging device measurement software. In a clinical trial of 50 wounds, wound dimensions were digitally measured and fluorescence images were acquired to assess for the presence of bacteria at moderate-to-heavy loads. Finally, fluorescence imaging was implemented into the routine assessment of 22 routine diabetic foot ulcers (DFU) to determine appropriate debridement level and location based on bacterial fluorescence signals. Results: Wound measurement accuracy was >95% (COV <3%). In the clinical trial of 50 wounds, 72% of study wounds demonstrated positive bacterial fluorescence signals. Levine sampling of wounds was found to under-report bacterial loads relative to fluorescence-guided curettage samples. Furthermore, fluorescence documentation of bacterial presence and location(s) resulted in more aggressive, fluorescence-targeted debridement in 17/20 DFUs after standard of care debridement failed to eliminate bacterial fluorescence in 100% of DFU debridements. Conclusion: The bacterial fluorescence imaging device can be readily implemented for objective, evidenced-based wound assessment and documentation at the bedside. Bedside localisation of regions with moderate-to-heavy bacterial loads facilitated improved sampling, debridement targeting and improved wound bed preparation.

scholarly journals 261.Probiotic Lactobacillus in seminal plasma

2004 ◽  
Vol 16 (9) ◽  
pp. 261 ◽  
Author(s):  
G. Sivaramakrishnan ◽  
M. J. Jasper ◽  
S. O'Leary ◽  
S. A. Robertson
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Real Time ◽  
Seminal Plasma ◽  
Pathogenic Bacteria ◽  
Reproductive Tract ◽  
Bacterial Species ◽  
Female Reproductive Tract ◽  
Plasma Samples ◽  
Culture Techniques

Commensal bacteria of the Lactobacillus genus are implicated in beneficial 'probiotic' roles in the gut and other mucosal tissues. Their presence reduces the incidence of pathogenic infections, both passively and via production of antimicrobial substances, and through Toll-like receptor-mediated activation of cytokine expression in host tissues. Lactobacilli are present in the female reproductive tract but have not been examined in the male. This study aimed to investigate, by selective culture techniques and real-time quantitative PCR, the prevalence in boar seminal plasma of Lactobacilli compared with other pathogenic bacteria. Using acidified Rogosa Agar, Lactobacilli were cultured from 3/3 fresh semen samples and were found to be most prevalent in the first fraction of the ejaculate. For PCR, DNA was extracted from reference bacterial cultures and archived seminal plasma samples from 40 healthy boars. Bacterial species-specific primers targeting Lactobacillus 16s and 16s-23s rDNA sequences, and Staphylococcus aureus, Pseudomonas aeruginosa, and Bacillus-specific Sau3AI, oprL, and 16s rDNA genes respectively, were used in real-time PCR assays employing SYBRgreen (Applied Biosystems) technology. Lactobacilli were detected in 22/40 (55%) of seminal plasma samples, while pathogenic bacteria were detected in <10% of samples (Staphylococcus aureus, 1/40; Pseudomonas aeruginosa, 2/40; and Bacillus, 3/40). The Lactobacillus content of individual boars ranged from 1.5 to 15 × 106 cells/mL, and within boars, content varied within 30% of the mean value in successive samples over a 6-month period. We conclude that Lactobacilli are present in abundance in boar seminal plasma compared to other potentially pathogenic bacteria. These bacteria may protect the male tract from pathogen infection, and after ejaculation, may influence the female immune response to male antigens. Ongoing studies will investigate whether Lactobacilli abundance in seminal plasma correlates with boar fertility, and examine the potential value of improving reproductive performance in pigs and other species by administration of probiotic agents.

scholarly journals Impact of home visits on the functional capacity of patients with venous ulcers

2017 ◽  
Vol 70 (2) ◽  
pp. 287-293 ◽  
Author(s):  
Fabiana Lopes Joaquim ◽  
Alessandra Conceição Leite Funchal Camacho ◽  
Rose Mary Costa Rosa Andrade Silva ◽  
Bruna Silva Leite ◽  
Raquel Santos de Queiroz ◽  
...  
Keyword(s):  
Functional Capacity ◽  
Wound Care ◽  
Home Visits ◽  
University Hospital ◽  
Controlled Study ◽  
Research Subjects ◽  
Evaluation Tool ◽  
Care Clinic ◽  
Venous Ulcers ◽  
The Impact

ABSTRACT Objective: to compare the impact of home visits, before and after instructions, on the functional capacity of adult and elderly patients with venous ulcers, by means of the KATZ-EIAVD Scale. Method: experimental, clinical, randomized, non-blind and controlled study, developed with 32 patients (case and control groups). The research settings were the Wound Care Clinic of the University Hospital Antonio Pedro, and the homes of patients assisted in this clinic. Data collection took place from February to June 2014, by means of a health unit evaluation tool, the KATZ-EIAVD Scale, and a script of instructions to be given to the research subjects that had received a home visit. Results: the studied population present excellent independence for activities of daily living, with no significant variation among them. Conclusion: the studied groups have functional capacity with similar progress.

scholarly journals Understanding Real-Time Fluorescence Signals from Bacteria and Wound Tissues Observed with the MolecuLight i:XTM

Diagnostics ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 22 ◽  
Author(s):  
Monique Rennie ◽  
Danielle Dunham ◽  
Liis Lindvere-Teene ◽  
Rose Raizman ◽  
Rosemary Hill ◽  
...  
Keyword(s):  
Real Time ◽  
Pathogenic Bacteria ◽  
Rapid Assessment ◽  
Image Interpretation ◽  
Specific Treatment ◽  
Patient Specific ◽  
Image Artifacts ◽  
Imaging Device ◽  
Fluorescence Characteristics ◽  
Heavy Loads

The persistent presence of pathogenic bacteria is one of the main obstacles to wound healing. Detection of wound bacteria relies on sampling methods, which delay confirmation by several days. However, a novel handheld fluorescence imaging device has recently enabled real-time detection of bacteria in wounds based on their intrinsic fluorescence characteristics, which differ from those of background tissues. This device illuminates the wound with violet (405 nm) light, causing tissues and bacteria to produce endogenous, characteristic fluorescence signals that are filtered and displayed on the device screen in real-time. The resulting images allow for rapid assessment and documentation of the presence, location, and extent of fluorescent bacteria at moderate-to-heavy loads. This information has been shown to assist in wound assessment and guide patient-specific treatment plans. However, proper image interpretation is essential to assessing this information. To properly identify regions of bacterial fluorescence, users must understand: (1) Fluorescence signals from tissues (e.g., wound tissues, tendon, bone) and fluids (e.g., blood, pus); (2) fluorescence signals from bacteria (red or cyan); (3) the rationale for varying hues of both tissue and bacterial fluorescence; (4) image artifacts that can occur; and (5) some potentially confounding signals from non-biological materials (e.g., fluorescent cleansing solutions). Therefore, this tutorial provides clinicians with a rationale for identifying common wound fluorescence characteristics. Clinical examples are intended to help clinicians with image interpretation—with a focus on image artifacts and potential confounders of image interpretation—and suggestions of how to overcome such challenges when imaging wounds in clinical practice.

scholarly journals Utility of a real-time fluorescence imaging device in guiding antibiotic treatment in superficial skin infections

2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Bhavika M. Shah ◽  
Devina Ganvir ◽  
Yugal K. Sharma ◽  
Shahzad Beg Mirza ◽  
R. N. Misra ◽  
...  
Keyword(s):  
Real Time ◽  
Fluorescence Imaging ◽  
Point Of Care ◽  
Fluorescent Imaging ◽  
Skin Infections ◽  
Imaging Device ◽  
Superficial Skin ◽  
Microbiological Testing ◽  
Infective Etiology

The prescription of antibiotics empirically without confirmation of an infective etiology is on the rise. Administration of appropriate antibiotics can be guided by real-time fluorescence imaging using a point-of-care device. These composite images show the presence, type and the burden of infection. The time saved by this method over microbiological testing, especially in resource-poor settings, can lead to a paradigm shift in treatment by facilitating prompt and adequate antimicrobial therapy, surgical debridement as well as follow-up. Thumbnail sketches of a series of four cases highlighting different scenarios in which a fluorescent imaging device utilizing artificial intelligence and machine learning was found useful is presented in this report.

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