Diagnostic Accuracy of Point-of-Care Fluorescence Imaging for the Detection of Bacterial Burden in Wounds: Results from the 350-Patient Fluorescence Imaging Assessment and Guidance Trial.
Diagnostic Accuracy of Point-of-Care Fluorescence Imaging for the Detection of Bacterial Burden in Wounds: Results from the 350-Patient Fluorescence Imaging Assessment and Guidance Trial.
复制标题
即时荧光成像检测伤口细菌负荷的诊断准确性：来自350例患者荧光成像评估和指导试验的结果。
DOI：
10.1089/wound.2020.1272
复制
发表时间：
2021-03
影响因子：
4.9
通讯作者：
Serena TE
中科院分区：
文献类型：
--
作者：
Le L;Baer M;Briggs P;Bullock N;Cole W;DiMarco D;Hamil R;Harrell K;Kasper M;Li W;Patel K;Sabo M;Thibodeaux K;Serena TE
目的：高细菌负荷导致伤口的慢性，并根据感染的临床体征和症状（CSS）进行诊断，但这些特征并不能很好地预测细菌负荷。点护理荧光成像（FL） MolecuLight i:X可以提高对高细菌负荷（>104菌落形成单位[CFU]/g）伤口的识别。FL检测浮游细菌或生物膜中的细菌，但不区分两者。本研究比较了FL与CSS在常规伤口评估中的诊断准确性。评估后，对临床医生进行调查，评估FL对治疗计划的影响。方法：一项前瞻性多中心对照研究由来自美国14个门诊高级伤口护理中心的20名临床医生进行。对伤口进行CSS和FL评估。收集活检以确认总细菌负荷。350例患者完成了研究（138例糖尿病足溃疡，106例下肢静脉溃疡，60例手术部位，22例压疮，24例其他）。结果：约有287/350个伤口（82%）细菌负荷为1010cfu /g，其中85%的伤口未检出CSS。FL显著增加了细菌检出率（bbb104cfu /g） 4倍，这在不同伤口类型中是一致的（p < 0.001）。CSS+FL的特异性仍高于CSS （p = 1.0）。据临床医生报告，FL信息修改了治疗计划（69%的伤口），影响了伤口床的准备（85%），改善了患者的整体护理（90%）。创新：这种新颖的非接触式，手持式FL设备提供即时，客观的信息，在护理点细菌的存在，位置和负荷。结论：使用FL有助于遵守临床指南，建议及时发现和清除细菌负担，以减少伤口感染并促进愈合。
Objective: High bacterial load contributes to chronicity of wounds and is diagnosed based on assessment of clinical signs and symptoms (CSS) of infection, but these characteristics are poor predictors of bacterial burden. Point-of-care fluorescence imaging (FL) MolecuLight i:X can improve identification of wounds with high bacterial burden (>104 colony-forming unit [CFU]/g). FL detects bacteria, whether planktonic or in biofilm, but does not distinguish between the two. In this study, diagnostic accuracy of FL was compared to CSS during routine wound assessment. Postassessment, clinicians were surveyed to assess impact of FL on treatment plan. Approach: A prospective multicenter controlled study was conducted by 20 study clinicians from 14 outpatient advanced wound care centers across the United States. Wounds underwent assessment for CSS followed by FL. Biopsies were collected to confirm total bacterial load. Three hundred fifty patients completed the study (138 diabetic foot ulcers, 106 venous leg ulcers, 60 surgical sites, 22 pressure ulcers, and 24 others). Results: Around 287/350 wounds (82%) had bacterial loads >104 CFU/g, and CSS missed detection of 85% of these wounds. FL significantly increased detection of bacteria (>104 CFU/g) by fourfold, and this was consistent across wound types (p < 0.001). Specificity of CSS+FL remained comparably high to CSS (p = 1.0). FL information modified treatment plans (69% of wounds), influenced wound bed preparation (85%), and improved overall patient care (90%) as reported by study clinicians. Innovation: This novel noncontact, handheld FL device provides immediate, objective information on presence, location, and load of bacteria at point of care. Conclusion: Use of FL facilitates adherence to clinical guidelines recommending prompt detection and removal of bacterial burden to reduce wound infection and facilitate healing.
登录
查看更多内容
影响因子：
5.7
作者：
Brem, Harold;Stojadinovic, Olivera;Tomic-Canic, Marjana
通讯作者：
Tomic-Canic, Marjana
影响因子：
9.4
作者：
BUCHANAN, K;HEIMBACH, DM;COYLE, MB
通讯作者：
COYLE, MB
影响因子：
2.9
作者：
Gardner, SE;Frantz, RA;Doebbeling, BN
通讯作者：
Doebbeling, BN
影响因子：
4.4
作者：
Cavallaro, Gabriele;Decaria, Leonardo;Rosato, Antonio
通讯作者：
Rosato, Antonio
影响因子：
1.4
作者：
Blumenthal, Emily;Jeffery, Steven L. A.
通讯作者：
Jeffery, Steven L. A.