Wound Culture

Overview :

A sample of material, such as pus or a portion of tissue, is taken from the wound, placed in a sterile container, and sent to the laboratory. In the laboratory, this material is spread over the surface of several different types of culture plates and placed in an incubator at body temperature for one to two days. A Gram stain is done by staining the slide with purple and red stains, then examining it under a microscope. If many white blood cells and bacteria are seen, it is an early confirmation of infection. The color of stain retained by the bacteria (purple or red), their shape (such as round or rectangular), and their size provides valuable clues as to their identity, and helps the physician predict which antibiotics might work best even before the entire test is completed. Bacteria that stain purple are called gram-positive; those that stain red are called gram-negative. Bacteria can be grouped into two categories: aerobes and anaerobes. Aerobes are bacteria that need oxygen to live; anaerobes live only where there is no oxygen. Deep wounds, closed-off from oxygen, are an ideal environment for an anaerobic infection to develop. Foul-smelling odor, gas, or gangrene at the infection site are signs of an infection caused by an anaerobic bacteria. Routine cultures typically only look for aerobic bacteria. If the physician tells the laboratory to include a culture for anaerobes, a portion of the wound sample will be put on culture plates, or in a tube of culture broth, and incubated in a special chamber without oxygen. Bacteria present in the wound sample will multiply and appear as visible colonies on the plates, or as cloudiness in the tube of broth. They are identified by the appearance of their colonies, the results of biochemical tests, and information from Gram staining part of the bacterial colony. A sensitivity test, also called an antibiotic susceptibility test, is also done. The bacteria are tested against different antibiotics to determine which will treat the infection by killing the bacteria. If the physician thinks the wound may be infected with a mold or yeast, a fungal culture is also done. The wound sample is spread on special culture plates that are treated to encourage the growth of mold and yeast. Different biochemical tests and stains are used to identify molds and yeast. Other more unusual microorganisms, such as Mycobacterium leprae, may be the cause of a wound infection. The physician must notify the laboratory to culture specifically for these more unusual microorganisms. The initial Gram stain result is available the same day, or in less than an hour if requested by the physician. An early report, known as a preliminary report, is usually available after one day. This report will tell if any microorganisms have yet been found, and, if so, their Gram stain appearance. For example, they may have the appearance of a gram-negative rod, or a gram-positive cocci (spherical shape). The final report, usually available in one to three days, includes complete identification, an estimate of the quantity of the microorganisms, plus a list of the antibiotics to which they are sensitive. Cultures for fungi and anaerobic bacteria may take two to three weeks. Wound culture is also called soft tissue culture, abscess culture, or wound culture and sensitivity.