A Comparison of Tissue versus Swab Culturing of Infected Diabetic Foot Wounds
Objective. To compare the efficacy of swabbing versus tissue biopsy for microbiological diagnosis of diabetic foot infection. Methods. This was a prospective trial. Fifty-six patients with diabetic foot infection were divided into the following 3 groups according to the PEDIS grading system: grade 2...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2016/8198714 |
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| author | Ying Huang Ying Cao Mengchen Zou Xiangrong Luo Ya Jiang Yaoming Xue Fang Gao |
| author_facet | Ying Huang Ying Cao Mengchen Zou Xiangrong Luo Ya Jiang Yaoming Xue Fang Gao |
| author_sort | Ying Huang |
| collection | DOAJ |
| description | Objective. To compare the efficacy of swabbing versus tissue biopsy for microbiological diagnosis of diabetic foot infection. Methods. This was a prospective trial. Fifty-six patients with diabetic foot infection were divided into the following 3 groups according to the PEDIS grading system: grade 2 (n=10), grade 3 (n=29), and grade 4 (n=17). Two specimens were collected from each wound for microbial culturing after debridement, including a superficial swab and a deep tissue punch biopsy specimen. Results. Swab culturing identified all of the microorganisms isolated from the corresponding deep tissue specimens in 9/10 of grade 2 wounds (90.0%), and this proportion decreased to 12/29 (41.4%) and 7/17 (41.2%) for grades 3 and 4 wounds, respectively (p=0.02). Moreover, the sensitivity for identifying Gram-negative bacteria, such as E. coli and Citrobacter, by swabbing was low (33.3%). In addition, some Gram-negative bacteria, such as Serratia and Ralstonia pickettii, were isolated from deep tissues but not from swabs. Conclusions. Swab culturing may be reliable for identification of pathogens in diabetic foot wounds classified as grade 2. However, it is advisable to culture deep tissue specimens for wounds of grade ≥3 because swab culturing is associated with a high risk of missing pathogens, especially Gram-negative bacteria. |
| format | Article |
| id | doaj-art-80f6497fa5ed4154a8bbd3496bd53ed5 |
| institution | OA Journals |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
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| series | International Journal of Endocrinology |
| spelling | doaj-art-80f6497fa5ed4154a8bbd3496bd53ed52025-08-20T02:08:53ZengWileyInternational Journal of Endocrinology1687-83371687-83452016-01-01201610.1155/2016/81987148198714A Comparison of Tissue versus Swab Culturing of Infected Diabetic Foot WoundsYing Huang0Ying Cao1Mengchen Zou2Xiangrong Luo3Ya Jiang4Yaoming Xue5Fang Gao6Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, ChinaObjective. To compare the efficacy of swabbing versus tissue biopsy for microbiological diagnosis of diabetic foot infection. Methods. This was a prospective trial. Fifty-six patients with diabetic foot infection were divided into the following 3 groups according to the PEDIS grading system: grade 2 (n=10), grade 3 (n=29), and grade 4 (n=17). Two specimens were collected from each wound for microbial culturing after debridement, including a superficial swab and a deep tissue punch biopsy specimen. Results. Swab culturing identified all of the microorganisms isolated from the corresponding deep tissue specimens in 9/10 of grade 2 wounds (90.0%), and this proportion decreased to 12/29 (41.4%) and 7/17 (41.2%) for grades 3 and 4 wounds, respectively (p=0.02). Moreover, the sensitivity for identifying Gram-negative bacteria, such as E. coli and Citrobacter, by swabbing was low (33.3%). In addition, some Gram-negative bacteria, such as Serratia and Ralstonia pickettii, were isolated from deep tissues but not from swabs. Conclusions. Swab culturing may be reliable for identification of pathogens in diabetic foot wounds classified as grade 2. However, it is advisable to culture deep tissue specimens for wounds of grade ≥3 because swab culturing is associated with a high risk of missing pathogens, especially Gram-negative bacteria.http://dx.doi.org/10.1155/2016/8198714 |
| spellingShingle | Ying Huang Ying Cao Mengchen Zou Xiangrong Luo Ya Jiang Yaoming Xue Fang Gao A Comparison of Tissue versus Swab Culturing of Infected Diabetic Foot Wounds International Journal of Endocrinology |
| title | A Comparison of Tissue versus Swab Culturing of Infected Diabetic Foot Wounds |
| title_full | A Comparison of Tissue versus Swab Culturing of Infected Diabetic Foot Wounds |
| title_fullStr | A Comparison of Tissue versus Swab Culturing of Infected Diabetic Foot Wounds |
| title_full_unstemmed | A Comparison of Tissue versus Swab Culturing of Infected Diabetic Foot Wounds |
| title_short | A Comparison of Tissue versus Swab Culturing of Infected Diabetic Foot Wounds |
| title_sort | comparison of tissue versus swab culturing of infected diabetic foot wounds |
| url | http://dx.doi.org/10.1155/2016/8198714 |
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