An Evaluation of Burn Wound Quantitative Microbiology: I. Quantitative Eschar Cultures

Abstract

The reliability of quantitative data from burn wound biopsy cultures was investigated. This was done by comparing the recovery of microorganisms from a series of burn wound eschar biopsy specimens that were each divided into two approximately equal portions and cultured in parallel. The results indicate that a microorganism present in the burn wound site in any quantity has at least a 25% chance of being missed by a single quantitative eschar culture. For recovery levels corresponding to quantitative breakpoints that have been proposed to be predictive of burn wound sepsis, only 38% of paired quantitative results agreed within the same log10 unit, and 44% differed by +/- 2 log10 units or more. These findings indicate that quantitative results derived from burn wound biopsy cultures are unreliable and may be significantly misleading when used for decision-making relative to patient care.