Department of Plastic Surgery, Korea University College of Medicine, Seoul, Korea.
Wounds. 2023 Jul;35(7):E218-E223. doi: 10.25270/wnds/23002.
DFUs are challenging chronic wounds that are vulnerable to infections. A fluorescence imaging device was developed to detect bacterial presence in wounds. This device utilizes the principle that when illuminated by violet light, some bacteria emit red fluorescence and others, such as Pseudomonas aeruginosa, emit cyan fluorescence. Several studies have reported the accuracy of this device. However, to the best of the authors' knowledge, no studies have examined the correlation between bacterial presence and tissue biopsy culture results in diabetic wounds.
This study aimed to investigate the diagnostic accuracy of a fluorescence imaging device using a tissue culture system.
Thirty-five patients (48 wounds) were included. Wounds were sampled using tissue culture methods and photographed using the fluorescence imaging device. Culture outcomes were categorized into non-Pseudomonas bacterial, Pseudomonas bacterial, both bacterial, and no-growth groups. Image outcomes were categorized into red, cyan, both colors, and negative groups.
For detecting the presence of bacteria, the fluorescence imaging device showed a sensitivity, specificity, PPV, and NPV of 64.1%, 55.6%, 86.2%, and 26.3%, respectively, with an accuracy of 62.5%. For P aeruginosa, the device showed a sensitivity, specificity, PPV, and NPV of 66.7%, 87.2%, 54.6%, and 91.9%, respectively, with an accuracy of 83.3%. For non-Pseudomonas bacteria, the device showed a sensitivity, specificity, PPV, and NPV of 43.8%, 62.5%, 70.0%, and 35.7%, respectively, with an accuracy of 50.0%.
The fluorescence imaging device can help to detect the bacterial bioburden; however, its accuracy may be lower than that reported in previous studies of diabetic wounds.
DFUs 是具有挑战性的慢性伤口，容易感染。已经开发出一种荧光成像设备来检测伤口中的细菌存在。该设备利用这样的原理，即当被紫光照射时，一些细菌发出红色荧光，而其他细菌，如铜绿假单胞菌，则发出青色荧光。已有多项研究报告了该设备的准确性。然而，据作者所知，尚无研究检查过糖尿病伤口中细菌存在与组织活检培养结果之间的相关性。
本研究旨在使用组织培养系统研究荧光成像设备的诊断准确性。
纳入 35 名患者（48 处伤口）。使用组织培养方法对伤口进行采样，并使用荧光成像设备对其进行拍照。培养结果分为非铜绿假单胞菌细菌、铜绿假单胞菌细菌、两种细菌和无生长组。图像结果分为红色、青色、两种颜色和阴性组。
在检测细菌存在方面，荧光成像设备的敏感性、特异性、PPV 和 NPV 分别为 64.1%、55.6%、86.2%和 26.3%，准确性为 62.5%。对于铜绿假单胞菌，该设备的敏感性、特异性、PPV 和 NPV 分别为 66.7%、87.2%、54.6%和 91.9%，准确性为 83.3%。对于非铜绿假单胞菌细菌，该设备的敏感性、特异性、PPV 和 NPV 分别为 43.8%、62.5%、70.0%和 35.7%，准确性为 50.0%。
荧光成像设备可帮助检测细菌生物负荷；然而，其准确性可能低于之前对糖尿病伤口的研究报告。
