Elsayed Sameer, Gregson Daniel B, Lloyd Tracie, Crichton Marilyn, Church Deirdre L
Division of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada.
Arch Pathol Lab Med. 2003 Nov;127(11):1485-8. doi: 10.5858/2003-127-1485-UOGSFT.
Surface swab cultures have attracted attention as a potential alternative to biopsy histology or quantitative culture methods for microbiological burn wound monitoring. To our knowledge, the utility of adding a Gram-stained slide in this context has not been evaluated previously.
To determine the degree of correlation of Gram stain with culture for the microbiological analysis of burn wound surfaces.
Prospective laboratory analysis.
Urban health region/centralized diagnostic microbiology laboratory.
Burn patients hospitalized in any Calgary Health Region burn center from November 2000 to September 2001.
Gram stain plus culture of burn wound surface swab specimens obtained during routine dressing changes or based on clinical signs of infection.
Degree of correlation (complete, high, partial, none), including weighted kappa statistic (kappa(w)), of Gram stain with culture based on quantitative microscopy and degree of culture growth.
A total of 375 specimens from 50 burn patients were evaluated. Of these, 239 were negative by culture and Gram stain, 7 were positive by Gram stain only, 89 were positive by culture only, and 40 were positive by both methods. The degree of complete, high, partial, and no correlation of Gram stain with culture was 70.9% (266/375), 1.1% (4/375), 2.4% (9/375), and 25.6% (96/375), respectively. The degree of correlation for all 375 specimens, as expressed by the weighted kappa statistic, was found to be fair (kappa(w) = 0.32).Conclusion.-The Gram stain is not suitable for the microbiological analysis of burn wound surfaces.
作为微生物学烧伤创面监测中活检组织学或定量培养方法的潜在替代方法，表面拭子培养已引起关注。据我们所知，在此背景下添加革兰氏染色玻片的效用此前尚未得到评估。
确定革兰氏染色与培养在烧伤创面微生物学分析中的相关程度。
前瞻性实验室分析。
城市卫生区域/集中诊断微生物学实验室。
2000年11月至2001年9月在卡尔加里任何卫生区域烧伤中心住院的烧伤患者。
对在常规换药期间或根据感染临床体征获取的烧伤创面拭子标本进行革兰氏染色加培养。
基于定量显微镜检查和培养生长程度，革兰氏染色与培养的相关程度（完全、高度、部分、无），包括加权kappa统计量（kappa(w)）。
共评估了50名烧伤患者的375份标本。其中，239份培养和革兰氏染色均为阴性，7份仅革兰氏染色为阳性，89份仅培养为阳性，40份两种方法均为阳性。革兰氏染色与培养的完全、高度、部分和无相关程度分别为70.9%（266/375）、1.1%（4/375）、2.4%（9/375）和25.6%（96/375）。用加权kappa统计量表示，所有375份标本的相关程度为中等（kappa(w)=0.32）。结论：革兰氏染色不适用于烧伤创面的微生物学分析。
