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

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1239
Author(s):  
Thomas E. Serena ◽  
Philip G. Bowler ◽  
Gregory S. Schultz ◽  
Anna D’souza ◽  
Monique Y. Rennie

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.

2020 ◽  
Vol 14 (S 01) ◽  
pp. S123-S129 ◽  
Author(s):  
Hiba Hamid ◽  
Zohaib Khurshid ◽  
Necdet Adanir ◽  
Muhammad S. Zafar ◽  
Sana Zohaib

AbstractNovel coronavirus disease 2019 (COVID-19) outbreak has termed as a controllable pandemic, and the entire world has come to a standstill trying to mitigate the disease with health systems. Health care providers, around the globe, are fighting day and night. Currently, rapid testing is taking place with the help of nasopharyngeal, oropharyngeal swab, bronchoalveolar lavage, sputum, urine, and blood. All these approaches are invasive or embarrassing to the infected person. It is observed that salivary glands are hosting severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) because of angiotensin-converting enzyme 2 and the detection of high viral loads in the saliva and is playing a crucial role in virus transmission, especially from individuals showing absolutely no symptoms. Saliva is proving to be a promising noninvasive sample specimen for the diagnosis of COVID-19, thus helping to monitor the infection and prevent it from further spreading by prompt isolation.


2012 ◽  
Vol 1 (3) ◽  
pp. 173-177 ◽  
Author(s):  
Walter Van Dyck ◽  
Gergely Vértes ◽  
Muhilan Palaniappan ◽  
Daniel Gassull ◽  
Prateek Jain ◽  
...  

2018 ◽  
Vol 19 (4) ◽  
pp. 326-344 ◽  
Author(s):  
Roger Davies ◽  
Kieran O’Dea ◽  
Anthony Gordon

Immune therapy to ease the burden of sepsis has thus far failed to consistently improve patient outcomes. Advances in cancer immune therapy and awareness that prolonged immune-suppression in sepsis can leave patients vulnerable to secondary infection and death have driven resurgence in the field of sepsis immune-therapy investigation. As we develop and evaluate these novel therapies, we must learn from past experiences where single-mediator targeted immune therapies were blindly delivered to heterogeneous patient cohorts with complex and evolving immune responses. Advances in genomics, proteomics, metabolomics, and point-of-care technology, coupled with a better understanding of sepsis pathogenesis, have meant that personalised immune-therapy is on the horizon. Here, we review the complex immune pathogenesis in sepsis and the contemporary immune therapies that are being investigated to manipulate this response. An outline of the immune biomarkers that may be used to support this approach is also provided.


2019 ◽  
Vol 72 (7) ◽  
pp. 474-481
Author(s):  
José M Ordóñez-Mena ◽  
Thomas R Fanshawe ◽  
David McCartney ◽  
Brian Shine ◽  
Ann Van den Bruel ◽  
...  

Aims C-reactive protein (CRP) and neutrophil count (NC) are important diagnostic indicators of inflammation. Point-of-care (POC) technologies for these markers are available but rarely used in community settings in the UK. To inform the potential for POC tests, it is necessary to understand the demand for testing. We aimed to describe the frequency of CRP and NC test requests from primary care to central laboratory services, describe variability between practices and assess the relationship between the tests.MethodsWe described the number of patients with either or both laboratory tests, and the volume of testing per individual and per practice, in a retrospective cohort of all adults in general practices in Oxfordshire, 2014–2016.Results372 017 CRP and 776 581 NC tests in 160 883 and 275 093 patients, respectively, were requested from 69 practices. CRP was tested mainly in combination with NC, while the latter was more often tested alone. The median (IQR) of CRP and NC tests/person tested was 1 (1–2) and 2 (1–3), respectively. The median (IQR) tests/practice/week was 36 (22–52) and 72 (50–108), and per 1000 persons registered/practice/week was 4 (3–5) and 8 (7–9), respectively. The median (IQR) CRP and NC concentrations were 2.7 (0.9–7.9) mg/dL and 4.1 (3.1–5.5)×109/L, respectively.ConclusionsThe high demand for CRP and NC testing in the community, and the range of results falling within the reportable range for current POC technologies highlight the opportunity for laboratory testing to be supplemented by POC testing in general practice.


PLoS ONE ◽  
2013 ◽  
Vol 8 (6) ◽  
pp. e67612 ◽  
Author(s):  
Matilu Mwau ◽  
Ferdinard Adungo ◽  
Silvia Kadima ◽  
Ephantus Njagi ◽  
Carolyne Kirwaye ◽  
...  

2007 ◽  
Vol 1 (3) ◽  
pp. 405-411 ◽  
Author(s):  
Bruce W. Bode ◽  
Benjamin R. Irvin ◽  
Jeffrey A. Pierce ◽  
Michael Allen ◽  
Annette L. Clark

2017 ◽  
Vol 5 (1) ◽  
pp. 93-100
Author(s):  
Rammohan V Maikala

Point-of-care or ‘near-patient’ testing has received attention in recent years for its usefulness in rapid and reliable delivery of healthcare to a patient in a variety of clinical settings. Near-infrared spectroscopy (NIRS)-derived optical biomarkers (e.g., tissue oxygen saturation) have been utilized to monitor tissue vascularity and oxygenation status continuously in normal and patient populations. Despite its ease of use and modest cost, the NIRS modality is still not at point-of-care use in the healthcare sector as extensively as other physiological modalities such as Pulse Oximetry. This short communication examines the case for point-of-care testing with two examples of FDA-approved NIRS systems, and discusses the feasibility and implementation of the NIRS modality as a point-of-care technology.


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