Rapid Diagnosis of Pseudomonas aeruginosa in Wounds with Point-Of-Care Fluorescence Imaing.
Rapid Diagnosis of Pseudomonas aeruginosa in Wounds with Point-Of-Care Fluorescence Imaing.
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DOI：
10.3390/diagnostics11020280
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发表时间：
2021-02-11
期刊：
影响因子：
--
通讯作者：
Smith AC
中科院分区：
文献类型：
--
作者：
Raizman R;Little W;Smith AC
铜绿假单胞菌（PA）是慢性伤口中常见的细菌病原体，已知其倾向于形成生物膜并逃避常规治疗方法。伤口中PA的早期检测对于减轻更严重的伤口结局至关重要。即时细菌荧光成像用安全的紫光照射伤口，触发PA产生青色荧光。进行了一项前瞻性单盲临床研究，以确定青色荧光检测伤口中PA的阳性预测值（PPV）。使用MolecuLight i：X成像设备的细菌荧光显示了28个慢性伤口中的青色荧光信号，包括静脉性腿部溃疡、手术伤口、糖尿病足溃疡和其他伤口类型。为了将青色信号与PA的存在相关联，通过刮除术对青色荧光阳性的伤口区域进行取样。刮除样本的半定量培养分析证实了26/28个伤口中存在PA，导致PPV为92.9%。来自青色阳性区域的PA的细菌负荷从轻到重不等。不到20%的PA阳性伤口表现出典型的PA感染症状。这些发现表明，在荧光图像上检测到的青色可用于可靠地预测细菌，特别是在护理点的PA。
Pseudomonas aeruginosa (PA) is a common bacterial pathogen in chronic wounds known for its propensity to form biofilms and evade conventional treatment methods. Early detection of PA in wounds is critical to the mitigation of more severe wound outcomes. Point-of-care bacterial fluorescence imaging illuminates wounds with safe, violet light, triggering the production of cyan fluorescence from PA. A prospective single blind clinical study was conducted to determine the positive predictive value (PPV) of cyan fluorescence for the detection of PA in wounds. Bacterial fluorescence using the MolecuLight i:X imaging device revealed cyan fluorescence signal in 28 chronic wounds, including venous leg ulcers, surgical wounds, diabetic foot ulcers and other wound types. To correlate the cyan signal to the presence of PA, wound regions positive for cyan fluorescence were sampled via curettage. A semi-quantitative culture analysis of curettage samples confirmed the presence of PA in 26/28 wounds, resulting in a PPV of 92.9%. The bacterial load of PA from cyan-positive regions ranged from light to heavy. Less than 20% of wounds that were positive for PA exhibited the classic symptoms of PA infection. These findings suggest that cyan detected on fluorescence images can be used to reliably predict bacteria, specifically PA at the point-of-care.
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