Q-Scoring System for the Evaluation of the Superficial Wound Swab Samples: A Clinical Microbiological Aspect

Wound swab cultures are frequently requested from patients suspected of having a wound infection. The quality of the sample should also be evaluated by performing a Gram-stained microscopic examination. "Q-scoring system" is not widely used and the literature on the subject is limited.

A total of 4648 wound swab samples were evaluated. Samples with a Q-score of "0" were considered as "poor quality samples", and those with a score of " ≥ 1" were classified as "good quality samples". Microorganisms grown in the culture of samples that scored above one were identified by mass spectrometry, and antimicrobial susceptibility testing was performed.

Gram stain results were found to be consistent with the culture result in 57.10% (n = 1078) of and inconsistent with the culture result in 42.90% (n = 813) of the samples. The number of samples with Q-scores one, two, and three among the 813 samples was 62, 29, and 722, respectively. The value observed in Q3 was found to be statistically significantly higher than the values observed in Q1 and Q2 (p < 0.05). Samples sent from surgical departments (61.92%) with a Q-score of ≥ 1, were statistically significant compared to internal medicine departments (p < 0.0001). There was no significant difference between samples sent from intensive care units and those sent from other inpatient services. For both groups with Q-scores ≥ 1 and "0" similar microorganisms were identified.

As a conclusion, the Q-scoring system will provide a common language between the laboratory and the clinic, especially by standardizing the evaluation of wound swab samples.