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Comparison of Quantitative Microbiology and Histopathology in Divided Burn-Wound Biopsy Specimens

Comparison of Quantitative Microbiology and Histopathology in Divided Burn-Wound Biopsy Specimens Abstract • We examined the association between quantitative microbiologic results and histopathologic findings in divided biopsy specimens from 200 burned patients. Microbiologic counts were determined as log10 colony-forming units per gram of disrupted tissue. Histopathologic results were scored on a scale of 1 to 6, values of 4 or greater indicating microbial invasion of viable tissue. Agreement of 96.1% was found between negative cultures, arbitrarily identified as those with fewer than 5 logs/g, and histologic absence of invasive infection. In sharp contrast, however, histologic invasion occurred in only 36% of specimens with positive cultures. Though low tissue counts are essentially synonymous with negative histologic findings, quantitative microbiology is not a diagnostic substitute for histologic examination, since high tissue counts quite commonly do not indicate invasion. The principal value of quantitative burn-wound biopsies is the demonstration of predominant burn-wound flora. (Arch Surg 1987;122:74-76) References 1. Brentano L, Gravens KL: A method for quantitation of bacteria in burn wounds . Appl Microbiol 1967;15:670-671. 2. Georgiade NG, Lucas MC, Osterhout S: A comparison of methods for the quantitation of bacteria in burn wounds: II. Clinical evaluation . Am J Clin Pathol 1970;53:40-42. 3. Loebl EC, Marvin JA, Heck EL, et al: The method of quantitative burn-wound biopsy cultures and its routine use in the care of the burned patient . Am J Clin Pathol 1974;61:21-24. 4. Levine NS, Lindberg RB, Mason AD Jr, et al: The quantitative swab culture and smear: A quick, simple method for determining the number of viable aerobic bacteria on open wounds . J Trauma 1976;16:89-94.Crossref 5. Woolfrey BF, Fox JMK, Quall BS: An evaluation of burn wound microbiology: The quantitative Gram stain . J Burn Care Rehabilitation 1982;3:171-175.Crossref 6. Boyle J, Roberts FJ, Snelling CFT, et al: Rapid, simple, and inexpensive method to rule out bacterial invasion of fat subjacent to full-thickness burn eschar . J Burn Care Rehabilitation 1985;6:402-407.Crossref 7. Pruitt BA Jr, Foley DF: The use of biopsies in burn patient care . Surgery 1973;73:887-897. 8. Pruitt BA Jr: Biopsy diagnosis of surgical infections . N Engl J Med 1984;310:1737-1738.Crossref 9. Kim SH, Hubbard GB, Worley BL, et al: A rapid section technique for burn wound biopsy . J Burn Care Rehabilitation 1985;6:433-435.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Comparison of Quantitative Microbiology and Histopathology in Divided Burn-Wound Biopsy Specimens

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1987.01400130080012
Publisher site
See Article on Publisher Site

Abstract

Abstract • We examined the association between quantitative microbiologic results and histopathologic findings in divided biopsy specimens from 200 burned patients. Microbiologic counts were determined as log10 colony-forming units per gram of disrupted tissue. Histopathologic results were scored on a scale of 1 to 6, values of 4 or greater indicating microbial invasion of viable tissue. Agreement of 96.1% was found between negative cultures, arbitrarily identified as those with fewer than 5 logs/g, and histologic absence of invasive infection. In sharp contrast, however, histologic invasion occurred in only 36% of specimens with positive cultures. Though low tissue counts are essentially synonymous with negative histologic findings, quantitative microbiology is not a diagnostic substitute for histologic examination, since high tissue counts quite commonly do not indicate invasion. The principal value of quantitative burn-wound biopsies is the demonstration of predominant burn-wound flora. (Arch Surg 1987;122:74-76) References 1. Brentano L, Gravens KL: A method for quantitation of bacteria in burn wounds . Appl Microbiol 1967;15:670-671. 2. Georgiade NG, Lucas MC, Osterhout S: A comparison of methods for the quantitation of bacteria in burn wounds: II. Clinical evaluation . Am J Clin Pathol 1970;53:40-42. 3. Loebl EC, Marvin JA, Heck EL, et al: The method of quantitative burn-wound biopsy cultures and its routine use in the care of the burned patient . Am J Clin Pathol 1974;61:21-24. 4. Levine NS, Lindberg RB, Mason AD Jr, et al: The quantitative swab culture and smear: A quick, simple method for determining the number of viable aerobic bacteria on open wounds . J Trauma 1976;16:89-94.Crossref 5. Woolfrey BF, Fox JMK, Quall BS: An evaluation of burn wound microbiology: The quantitative Gram stain . J Burn Care Rehabilitation 1982;3:171-175.Crossref 6. Boyle J, Roberts FJ, Snelling CFT, et al: Rapid, simple, and inexpensive method to rule out bacterial invasion of fat subjacent to full-thickness burn eschar . J Burn Care Rehabilitation 1985;6:402-407.Crossref 7. Pruitt BA Jr, Foley DF: The use of biopsies in burn patient care . Surgery 1973;73:887-897. 8. Pruitt BA Jr: Biopsy diagnosis of surgical infections . N Engl J Med 1984;310:1737-1738.Crossref 9. Kim SH, Hubbard GB, Worley BL, et al: A rapid section technique for burn wound biopsy . J Burn Care Rehabilitation 1985;6:433-435.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jan 1, 1987

References