Comparison of quantitative and semiquantitative culture techniques for burn biopsy

Accurate evaluation of bacterial colonization as a predictive index for wound sepsis has relied on a quantitative culture technique that provides exact colony counts per gram of tissue by culture of five serial dilutions of biopsy tissue homogenate. The method, while useful to the physician, is both labor intensive and expensive. In this study 78 eschar biopsies were cultured by a semiquantitative technique that involved the use of 0.1- and 0.01-ml samples of inocula and by the serial dilution method. Exact colony counts from the semiquantitative culture method were available only from cultures containing 10(4) to 10(6) CFU/g of tissue. Other colony counts were reported as less than 10(4) or greater than 10(6) CFU/g. Agreement by category of colony counts between the two methods was 96%. For prediction of wound sepsis, the semiquantitative procedure had a positive predictive value of 100% and a negative predictive value of 93.7%. This method also resulted in an approximately 30% reduction of work units (as defined by the College of American Pathologists) and a 60% reduction in the amount of media for specimen processing. Therefore, this semiquantitative culture technique provides accurate information to the physician while saving both time and materials.