Related Experiment Videos
Comparison of wound culture and bronchial lavage in the severely burned child: implications for antimicrobial therapy
P I Ramzy1, D N Herndon, S E Wolf
1Department of Surgery, Shriner's Burn Hospital, University of Texas Medical Branch, Galveston, USA. pramzy@sbi.utmb.edu
Insights
Quantitative wound cultures (QWC) and bronchial lavage fluid (BLF) cultures showed similar microbes in burn patients. However, QWC cannot predict BLF results, necessitating independent testing for antimicrobial therapy.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Burn Management
Background:
- The relationship between burn wound flora and tracheobronchial pathogens is crucial for guiding antimicrobial therapy in severely burned patients.
- Surveillance quantitative wound cultures (QWC) and bronchial lavage fluid (BLF) cultures aid in managing septic complications.
Purpose of the Study:
- To compare microbial organisms identified in BLF with those from QWC.
- To assess the predictive value of QWC for BLF culture findings in burn patients.
Main Methods:
- Comparison of BLF culture results with QWC data from the same patient cohort over a one-year period.
- Matching criteria included identical antibiotic susceptibility patterns and biotypes.
- Qualitative and quantitative match rates were calculated.
Main Results:
- A qualitative match between BLF and QWC organisms was observed in 48% of cases (30/62).
- Applying strict quantitative criteria reduced the match rate to 14% (9/62).
- Burn size and inhalation injury did not significantly impact the match rate.
Conclusions:
- While microbial pathogens in QWC and BLF were often similar, QWC did not predict BLF results.
- Discrepancies between qualitative and quantitative matches suggest cross-colonization rather than cross-infection.
- Independent performance of QWC and BLF cultures is essential for determining appropriate antimicrobial specificity in burn patients.
Background:
The relationship of the burn wound flora to microbial pathogens in the tracheobronchial tree has important implications for antimicrobial therapy in the severely burned patient. Management of septic complications is bolstered by surveillance quantitative wound cultures (QWC) and bronchial lavage fluid (BLF) cultures.
Objectives:
To compare the organisms present in BLF with those found in QWC and to determine if QWC can predict BLF results.
Design:
Results of BLF cultures from all patients who underwent bronchial lavage from January 1, 1996, to December 31, 1996, at our institution were compared with QWC data from the same date. Criteria for a positive match included an identical antibiotic susceptibility pattern and biotype. Match rates were calculated qualitatively and quantitatively.
Results:
In 30 (48%) of the 62 BLF cultures, there was a match between the organism identified in the BLF and the QWC. When strict quantitative criteria were applied, the match rate was only 9 (14%) of 62. Burn size and inhalation injury had no significant effect on match rate.
Conclusions:
Whereas the microbial pathogens were similar in the QWC and BLF, linear regression showed no value of QWC in predicting BLF culture results. The difference between qualitative and quantitative match rates suggests cross-colonization between the burn wound and tracheobronchial tree, but little to no cross-infection. The QWC and BLF cultures must be performed independently in determining antimicrobial specificity in the burned patient.
Related Concept Videos
01:20Sputum Studies II: Culture and Sensitivity
Sputum culture and sensitivity is a medical procedure used to diagnose bacterial infections in the respiratory tract and select the most appropriate antibiotics for treatment. This process involves analyzing sputum samples of thick and opaque secretions produced in the lungs and airways. These samples are collected from patients and then sent to the laboratory for analysis.
The test can identify various pathogens responsible for respiratory infections, including Streptococcus,...
01:22Burn Injuries
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...