The rapid detection of wound pathogens (frequently mixed bacteria and fungi) can dramatically improve the outcome for a patient who may otherwise experience life-threatening complications. In fact, over 6.5 million people deal with chronic, non-healing wounds every year, many of which tend to rely on traditional methods of wound testing to understand why the infection is taking so long to improve or failing to respond to therapy. A Wound Pathogen panel is an important part of this and requires further study to improve it’s research.
Why is it important to improve wound pathogen testing?
Wound infections are usually polymicrobial – meaning consisting of many many different organisms, which may explain why a wound won’t heal. And this problem is very expensive to solve for everyone in the healthcare system. Traditionally patients need individual culture tests in order to detect a single specific pathogen causing a wound infection, which is time-intensive, expensive, and often inconclusive, and nearly impossible when dealing with complicated polymicrobial infections..
However, there is good news! With recent advancements in technology there has been significant improvements in wound testing which offers a fast, reliable, and cost-effective solution to identifying pathogens which can cause infection, even when these organisms are present in a mixed infection. Not only does this provide a better plan for patient treatment, but also leads to significantly lower healthcare costs due to a reduction of tests and procedures.
In this article, we’re going to discuss how novel diagnostic tools are improving wound pathogen testing along with how it’s benefiting patients and healthcare providers.
What Causes A Wound Infection?
It’s important to understand that your skin is the first layer of security against invading organisms and operates like a protective layer defending you against pathogens daily.
However, if you’re a patient with preexisting issues (for example, diseases like diabetes that may affect circulation) then a wound infection can quickly make a skin injury – like a cut or surgery – go from normal expected healing to a downright nightmare.
This is due to a pre-existing layer of bacteria and fungi – your normal flora – which in normal conditions carpet on your skin and do no harm to you – that now has the opportunity to colonize and infect the wound.
It’s not even necessary for a major trauma for a wound to get infected. In people with immune system disorders, a simple walk on the beach and cutting your foot on a seashell can cause a severe wound infection.
For reference, a wound pathogen panel will test for 2 primary sources of wound infection:
- Bacteria – micro-scopic single cell organisms with both harmful and beneficial qualities.
- Fungi – plant-like organisms that don’t make chlorophyll.
How Wound Pathogen Panel Technology Works
Wound panels work by analyzing the genetic material (DNA and RNA) of the pathogens present within a wound.
After the sample is collected, the lab performs polymerase chain reaction (PCR) testing to quickly identify which pathogens are present within the wound. A PCR test works by amplifying and detecting genetic material, providing a significantly more comprehensive and accurate diagnosis.
The first step with any wound pathogen panel is for a physician to collect a sample from the wound. This sample is done with a flocked tipped specimen swab (similar to a Q-tip).
Once the sample is collected, it is sent to a laboratory where it will undergo the preparation steps necessary for a proper PCR test (this includes breaking down the sample and extracting the genetic material present).
The reason PCR testing is chosen as the new standard for a wound pathogen panel is the accuracy, reliability, and speed provided. PCR tests are incredibly sensitive with the unique ability to detect the presence, or absence of a pathogen even with a smaller sample size. It’s far more precise compared to traditional culture tests which have historically been used.
In addition to the accuracy provided, a PCR test can produce results within 24 hours which can speed up the treatment plan for patients who may be experiencing life-threatening infections.
Benefits Of Wound Pathogen Panel Technology
Recent advancements in testing technology have led to reliable benefits for both patients and healthcare providers across the globe. These benefits range from increased speed in diagnosis (where speed to treatment is critical for saving a patient’s life) to reduced expenses. Here are a couple of examples of the benefits:
Accurate Diagnosis
Diagnostic testing for pathogens has traditionally been done with culture-based techniques which can often take days to provide a result. And unfortunately, due to your skin’s normal flora, this culture could often get contaminated leading to an inconclusive result.
However, with PCR testing not only can the results be provided quickly (often within 24 hours) but with the ability to detect against a wide range of pathogens. This is a critical improvement to infection diagnosis because it can provide an individualized plan for treatment which can lead to faster healing and significantly reduce the risk for complications.
Tailored Treatment
With the ability to detect a wide-range of pathogens due to PCR testing, healthcare providers will be able to provide a treatment plan tailored to the specific needs of the patient. This is a massive benefit to the patient who will no longer need to take broad-spectrum antibiotics (which can seriously affect the beneficial bacteria within your intestines or on your skin) and will be able to take specific medication suited for the targeted pathogen(s).
It’s well known that pathogens respond differently to the innumerable antibiotics or antifungals and instead of going with a “shotgun” approach, the healthcare provider can be more specific with targeted treatment. This will reduce the risk for antimicrobial resistance, along with improving the healing time for patients.
Number Of Tests
As mentioned earlier, traditional wound pathogen testing required the use of cultures for providing diagnosis.
The problem?
This method would require multiple tests to be performed to isolate the various different pathogens (which are likely plentiful) to provide a diagnosis.
With a PCR test you’re getting a comprehensive panel completed within a single test, which leads to significantly lower healthcare costs across the board.
Example of Types of Pathogens Identified by the Panel
Gram Negative
- Acinetobacter baumannii
- Bacteroides spp.
- Citrobacter freundii
- Clostridium novyi
- Clostridium septicum
- Clostridium perfringens
- Enterobacter aerogenes
- Enterobacter cloacae
- Escherichia coli
- Kingella kingae
- Klebsiella oxytoca
- Klebsiella pneumoniae
- Morganella morganii
- Proteus mirabilis
- Proteus vulgaris
- Pseudomonas aeruginosa
Gram Positive
- Enterococcus faecalis
- Enterococcus faecium
- Staphylococcus aureus
- Streptococcus pyogenes
Candida Panel
- Candida albicans
- Candida glabrata
- Candida krusei
- Candida lusitaniae
- Candida tropicalis
- Candida parapsilosis
Resistance Markers
- mecA
- AmpC
- Carbapenem
- ESBL
- Macrolide
- Quinolone-Fluoroquinolone
- Vancomycin
Conclusion
As you can see, wound pathogen panel technology is quickly becoming a game-changer for diagnosing wound infections for both patients and healthcare providers. These technological y advancements provide numerous benefits which include faster diagnosis, tailored treatment, and a reduction in the number of tests. If you’re interested in learning more, contact Lux Diagnostics for more information.
Frequently Asked Questions
What are the most common wound pathogens?
Staphylococcus aureus – a type of bacteria commonly found on the skin and in the nose that can cause infections if it enters the body through a wound.
Streptococcus pyogenes – a bacteria that can cause skin infections, including impetigo, erysipelas, and cellulitis.
Pseudomonas aeruginosa – a bacteria commonly found in soil, water, and other moist environments that can cause infections in wounds, especially burn wounds.
Klebsiella pneumoniae – a bacteria that is part of the normal flora in the mouth, skin, and intestines but can cause infections if it enters the body through a wound.
Proteus mirabilis – a bacteria commonly found in the intestines and urinary tract that can cause infections in wounds.
What are 3 classic signs of wound infection?
The 3 classic signs of a wound infection are:
- Redness
- Warmth
- Swelling
There are some other more subtle signs like smell, pain, and contact bleeding.
Indicators of wound infection include redness, swelling, purulent exudate, smell, pain, and systemic illness in the absence of other foci. Subtle signs of local wound infection include unhealthy “foamy” granulation tissue, contact bleeding, tissue breakdown, and epithelial bridging.
