Blackshaw Ellen L, Jeffery Steven L A
University of Birmingham, Birmingham, UK.
Consultant Plastic Surgeon; University of Birmingham, Birmingham, UK; Queen Elizabeth Hospital, Birmingham, UK.
J Wound Care. 2018 Jan 2;27(1):20-26. doi: 10.12968/jowc.2018.27.1.20.
Current standard diagnostic practice of bacterial infections by visual inspection under white light is subjective, and microbiological sampling is suboptimal due to high false negative rates and the lengthy time needed for culture results to arrive. The MolecuLight i:X Imaging Device attempts to combat the issues faced in standard practice by providing a non-contact, real-time method of visualising bacteria within wounds. Our aim was to test this imaging device in a series of patients.
A single-centre prospective observational study was conducted in the Queen Elizabeth Hospital, Birmingham. During Plastic Surgery Outpatient dressings clinics, patients had their wounds photographed with the imaging device under white light and violet light illumination. Microbiological swabs were obtained of all the wounds. Any clinical signs and symptoms of infection were noted. White light and violet light photographs were compared with correlate visible clinical signs and symptoms with auto-fluorescence images. Auto-fluorescence images were then compared with the microbiological swab results to discern any differences.
There were 14 patients with seventeen separate wounds imaged. Of the 17, eight wounds were positive for bacterial growth on microbiological culture. All eight of these were detected positive for bacteria according to auto-fluorescence imaging. There was one wound was detected positive for bacteria by auto-fluorescence imaging with negative microbiological results.
This study demonstrated the potential benefit of the imaging device due to the correlation between microbiological test results and auto-fluorescence imaging. The device greatly reduces the time taken waiting for results and it is simple, quick to use and non-contact. There is potential for the imaging device to guide swab sampling and aid health professionals in the diagnosis and management of wound infections.
目前通过白光目视检查诊断细菌感染的标准做法具有主观性，且微生物采样因假阴性率高和培养结果所需时间长而不尽人意。MolecuLight i:X成像设备试图通过提供一种非接触式实时可视化伤口内细菌的方法来解决标准做法中面临的问题。我们的目的是在一系列患者中测试这种成像设备。
在伯明翰伊丽莎白女王医院进行了一项单中心前瞻性观察研究。在整形门诊换药诊所，使用成像设备在白光和紫光照明下对患者的伤口进行拍照。对所有伤口进行微生物拭子采样。记录任何感染的临床体征和症状。将白光和紫光照片进行比较，以将可见的临床体征和症状与自发荧光图像相关联。然后将自发荧光图像与微生物拭子结果进行比较，以辨别任何差异。
对14例患者的17处不同伤口进行了成像。在这17处伤口中，8处伤口的微生物培养显示细菌生长呈阳性。根据自发荧光成像，所有这8处伤口均检测出细菌呈阳性。有一处伤口通过自发荧光成像检测出细菌呈阳性，但微生物学结果为阴性。
由于微生物检测结果与自发荧光成像之间的相关性，本研究证明了该成像设备的潜在益处。该设备大大减少了等待结果的时间，并且操作简单、使用快捷且非接触式。该成像设备有潜力指导拭子采样，并帮助卫生专业人员诊断和管理伤口感染。
