Potential pitfalls of quantitative burn wound biopsy cultures

We present our experience with clinical correlation of quantitative cultures. A total of 285 cultures in 18 patients were carried out according to the technique of burn wound biopsy culture. The predominant organism by far was Pseudomonas aeruginosa, followed by mixed Pseudomonas and Staphylococcus and Staphylococcus alone. There were two areas of divergence from classic correlations between biopsy results and the clinical course of the patient: data are presented from clinical burn wound sepsis and falsely low quantitative cultures, and from clinically aseptic patients pursuing a benign course with falsely high quantitative cultures. We believe that culture results must be interpreted in the light of total body surface area involved rather than as an isolated finding. Quantitative burn wound cultures are a useful guide to the management of burn patients, but must be interpreted in conjunction with clinical findings.