Diagnostic Validity of Three Quantitative Swab Techniques for Identifying Chronic Wound Infection

2.50
Hdl Handle:
http://hdl.handle.net/10755/159023
Type:
Presentation
Title:
Diagnostic Validity of Three Quantitative Swab Techniques for Identifying Chronic Wound Infection
Abstract:
Diagnostic Validity of Three Quantitative Swab Techniques for Identifying Chronic Wound Infection
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2006
Author:Gardner, Sue, PhD, RN
P.I. Institution Name:University of Iowa
Title:Assistant Professor
Contact Address:College of Nursing, 320 NB, Iowa City, IA, 52242, USA
Contact Telephone:319-335-7037
Co-Authors:Rita A. Frantz, PhD, RN, FAAN, Professor; Charles L. Saltzman, MD, Professor; Stephen L. Hillis, PhD, Biostatistician; Heeok Park, MSN, Graduate Research Assistant and Melody Scherubel, BSN, Research Assistant
The purpose of this study was to examine the diagnostic validity of three different quantitative swab techniques in identifying chronic wound infection. Concurrent swab specimens of non-arterial, chronic wounds were obtained using 1) wound exudate, 2) Z-technique, and 3) Levine technique. After acquisition of the swab specimens, a specimen of viable wound tissue was obtained. Swab and tissue specimens were processed and cultured using quantitative laboratory procedures. Infected wounds were defined as those containing 1,000,000 or more organisms per gram of tissue based on wound tissue cultures (gold standard). Accuracy was determined by associating the quantitative culture findings of each swab specimen with the culture findings from tissue specimens using receiver operating characteristic curves. Of the 83 study wounds, 30 (36%) were infected. The accuracy rate for discriminating between infected and non-infected wounds was highest for swab specimens obtained using Levine's technique at .80. Based on Levine's technique, a critical threshold of 37,000 organisms per swab provided a sensitivity of 90% and specificity of 57%. The concordance between specific microbial species isolated from Levine's specimens and those isolated from tissue specimens was 78%. The findings suggest that wound swab specimens collected using Levine's technique provide a reasonably accurate measure of wound bioburden given that they are much less invasive and more widely applicable than cultures based on tissue specimens. The diagnostic validity of Levine's technique needs further study using an alternative gold standard, such as the development of infection-related complications. This study was funded by The Department of Veteran's Affairs, Health Services Research and Development, Nursing Research Initiative (NRI-01-005-1) and the National Institutes of Health, National Institute of Nursing Research (NINR RO1 NRO7721).
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDiagnostic Validity of Three Quantitative Swab Techniques for Identifying Chronic Wound Infectionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/159023-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Diagnostic Validity of Three Quantitative Swab Techniques for Identifying Chronic Wound Infection</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Gardner, Sue, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Iowa</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">College of Nursing, 320 NB, Iowa City, IA, 52242, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">319-335-7037</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">sue-gardner@uiowa.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Rita A. Frantz, PhD, RN, FAAN, Professor; Charles L. Saltzman, MD, Professor; Stephen L. Hillis, PhD, Biostatistician; Heeok Park, MSN, Graduate Research Assistant and Melody Scherubel, BSN, Research Assistant</td></tr><tr><td colspan="2" class="item-abstract">The purpose of this study was to examine the diagnostic validity of three different quantitative swab techniques in identifying chronic wound infection. Concurrent swab specimens of non-arterial, chronic wounds were obtained using 1) wound exudate, 2) Z-technique, and 3) Levine technique. After acquisition of the swab specimens, a specimen of viable wound tissue was obtained. Swab and tissue specimens were processed and cultured using quantitative laboratory procedures. Infected wounds were defined as those containing 1,000,000 or more organisms per gram of tissue based on wound tissue cultures (gold standard). Accuracy was determined by associating the quantitative culture findings of each swab specimen with the culture findings from tissue specimens using receiver operating characteristic curves. Of the 83 study wounds, 30 (36%) were infected. The accuracy rate for discriminating between infected and non-infected wounds was highest for swab specimens obtained using Levine's technique at .80. Based on Levine's technique, a critical threshold of 37,000 organisms per swab provided a sensitivity of 90% and specificity of 57%. The concordance between specific microbial species isolated from Levine's specimens and those isolated from tissue specimens was 78%. The findings suggest that wound swab specimens collected using Levine's technique provide a reasonably accurate measure of wound bioburden given that they are much less invasive and more widely applicable than cultures based on tissue specimens. The diagnostic validity of Levine's technique needs further study using an alternative gold standard, such as the development of infection-related complications. This study was funded by The Department of Veteran's Affairs, Health Services Research and Development, Nursing Research Initiative (NRI-01-005-1) and the National Institutes of Health, National Institute of Nursing Research (NINR RO1 NRO7721).</td></tr></table>en_GB
dc.date.available2011-10-26T21:37:40Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:37:40Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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