M Haalboom1, M H E Blokhuis-Arkes2, R J Beuk2, R Meerwaldt2, R Klont3, M J Schijffelen3, P B Bowler4, M Burnet5, E Sigl6, J A M van der Palen7. 1. Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands; Department of Vascular Surgery, Medisch Spectrum Twente, Enschede, The Netherlands. Electronic address: M.Haalboom@mst.nl. 2. Department of Vascular Surgery, Medisch Spectrum Twente, Enschede, The Netherlands. 3. Department of Medical Microbiology, Medisch Spectrum Twente, Enschede, The Netherlands; Department of Bacteriology, Laboratorium Microbiologie Twente-Achterhoek, Hengelo, The Netherlands. 4. Science and Technology, ConvaTec Global Development Centre, Deeside, UK. 5. Synovo, Tübingen, Germany. 6. Qualizyme Diagnostics, Graz, Austria. 7. Department of Vascular Surgery, Medisch Spectrum Twente, Enschede, The Netherlands; Department of Research Methodology, Measurement and Data Analysis, University of Twente, Drienerlolaan Enschede, The Netherlands.
Abstract
OBJECTIVES: The aim of this study was to determine whether assessment of wound infection differs when culture results from wound biopsy versus wound swab are available in clinical practice. METHODS: For 180 eligible patients, a swab and biopsy were taken from one wound during a regular appointment at a wound care facility in eastern Netherlands. Culture results from both methods were supplemented with clinical information and provided to a panel of six experts who independently assessed each wound as infect or not, separately for swab and biopsy. Assessments for biopsy and swab were compared for the complete expert panel, and for individual experts. RESULTS: The complete expert panel provided the same wound assessment based on (clinical information and) culture results from wound biopsy and wound swab in 158 of 180 wounds (87.8%, kappa 0.67). For individual experts, agreement between biopsy and swab varied between 77% and 96%. However, there were substantial differences between experts: the same assessment was provided in 62 (34.4%) to 76 (42.2%) wounds for swab and biopsy respectively. CONCLUSIONS: Assessment of infection does not significantly differ when culture results from swabs or biopsies are available. The substantial variability between individual experts indicates non-uniformity in the way wounds are assessed. This complicates accurate detection of infection and comparability between studies using assessment of infection as reference standard.
OBJECTIVES: The aim of this study was to determine whether assessment of wound infection differs when culture results from wound biopsy versus wound swab are available in clinical practice. METHODS: For 180 eligible patients, a swab and biopsy were taken from one wound during a regular appointment at a wound care facility in eastern Netherlands. Culture results from both methods were supplemented with clinical information and provided to a panel of six experts who independently assessed each wound as infect or not, separately for swab and biopsy. Assessments for biopsy and swab were compared for the complete expert panel, and for individual experts. RESULTS: The complete expert panel provided the same wound assessment based on (clinical information and) culture results from wound biopsy and wound swab in 158 of 180 wounds (87.8%, kappa 0.67). For individual experts, agreement between biopsy and swab varied between 77% and 96%. However, there were substantial differences between experts: the same assessment was provided in 62 (34.4%) to 76 (42.2%) wounds for swab and biopsy respectively. CONCLUSIONS: Assessment of infection does not significantly differ when culture results from swabs or biopsies are available. The substantial variability between individual experts indicates non-uniformity in the way wounds are assessed. This complicates accurate detection of infection and comparability between studies using assessment of infection as reference standard.
Authors: Morag Clinton; Adam J Wyness; Samuel A M Martin; Andrew S Brierley; David E K Ferrier Journal: BMC Microbiol Date: 2021-11-10 Impact factor: 3.605