Efficacy of a bacterial fluorescence imaging device in an outpatient wound care clinic: a pilot study
Efficacy of a bacterial fluorescence imaging device in an outpatient wound care clinic: a pilot study
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DOI：
10.12968/jowc.2019.28.7.438
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发表时间：
2019-07-02
影响因子：
1.9
通讯作者：
Kelly, Jason E.
中科院分区：
文献类型：
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作者：
Hurley, Ciaran M.;McClusky, Pat;Kelly, Jason E.
目的：在标准伤口检查方案中，可能会遗漏皮下细菌负荷。实时细菌荧光成像设备MolecuLight i：X通过内源性自发荧光可视化潜在有害水平的细菌的存在，而无需造影剂或与患者接触。成像设备的预期用途是通过实时可视化潜在有害细菌来辅助管理伤口患者。本研究的目的是建立准确的伤口成像设备在检测病原菌在wounds.Methods：一个单中心，前瞻性的观察性研究进行了科克大学医院在门诊整形外科伤口护理诊所。用成像装置在白色和自体荧光灯下对患者的伤口进行拍照。结果：共纳入33例患者和43个拭子，其中95.3%（n=41）为细菌生长阳性。金黄色葡萄球菌是最常见的细菌菌种。该成像装置在荧光成像上识别伤口中病理性细菌存在的灵敏度为100%，特异性为78%。阳性预测值（PPV）为95.4%。阴性预测值（NPV）为100%。它表现出100%的灵敏度和特异性在检测假单胞菌的存在。结论：所使用的成像设备可以是一种安全，有效，准确和易于使用的自体荧光设备，以提高在门诊诊所设置的伤口评估。结合最佳临床实践，该器械可用于指导临床医生使用抗生素和专用敷料。
Objective: Subsurface bacterial burden can be missed during standard wound examination protocols. The real-time bacterial fluorescence imaging device, MolecuLight i:X, visualises the presence of potentially harmful levels of bacteria through endogenous autofluorescence, without the need for contrast agents or contact with the patient. The intended use of the imaging device is to assist with the management of patients with wounds by enabling real-time visualisation of potentially harmful bacteria. The aim of this study was to establish the accuracy of the wound imaging device at detecting pathogenic bacteria in wounds.Methods: A single-centre, prospective observational study was conducted in Cork University Hospital in an outpatient plastic surgery wound care clinic. Patients had their wounds photographed under white and autofluorescent light with the imaging device. Auto-fluorescent images were compared with the microbiological swab results.Results: A total of 33 patients and 43 swabs were included, of which 95.3% (n=41) were positive for bacteria growth. Staphylococcus aureus was the most common bacterial species identified. The imaging device had a sensitivity of 100% and specificity of 78% at identifying pathological bacteria presence in wounds on fluorescent light imaging. The positive predictive value (PPV) was 95.4%. The negative predictive value (NPV) was 100%. It demonstrated a sensitivity and specificity of 100% at detecting the presence of Pseudomonas spp.Conclusion: The imaging device used could be a safe, effective, accurate and easy-to-use autofluorescent device to improve the assessment of wounds in the outpatient clinic setting. In conjunction with best clinical practice, the device can be used to guide clinicians use of antibiotics and specialised dressings.