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Comparison of Quantitative Microbiology and Histopathology in Divided Burn-Wound Biopsy Specimens

Albert T. McManus, PhD; Seung H. Kim, MD; William F. McManus, MD; Arthur D. Mason Jr, MD; Basil A. Pruitt Jr, MD
Arch Surg. 1987;122(1):74-76. doi:10.1001/archsurg.1987.01400130080012.
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• We examined the association between quantitative microbiologic results and histopathologic findings in divided biopsy specimens from 200 burned patients. Microbiologic counts were determined as log10 colony-forming units per gram of disrupted tissue. Histopathologic results were scored on a scale of 1 to 6, values of 4 or greater indicating microbial invasion of viable tissue. Agreement of 96.1% was found between negative cultures, arbitrarily identified as those with fewer than 5 logs/g, and histologic absence of invasive infection. In sharp contrast, however, histologic invasion occurred in only 36% of specimens with positive cultures. Though low tissue counts are essentially synonymous with negative histologic findings, quantitative microbiology is not a diagnostic substitute for histologic examination, since high tissue counts quite commonly do not indicate invasion. The principal value of quantitative burn-wound biopsies is the demonstration of predominant burn-wound flora.

(Arch Surg 1987;122:74-76)

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