CAP Pro Course - Microbiology - The Microbiology of Wounds

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Author: Hallee Waye, BS, MLS (ASCP)CM
Reviewer: Alexandru Casapu, MBA, MLS(ASCP)CM, PBTCM

Continuing Education Credits

Objectives

  • Identify the optimal specimen types to be submitted for assessment of various wound infections.
  • Define appropriate methods for wound culture collection and describe how the specimen type may impact the clinical relevance of the results.
  • Outline appropriate specimen processing and plating for wound culture specimens.
  • Be able to list the common pathogens isolated from wound cultures, describe their Gram stain result and appearance on routine culture media.
  • Describe different strategies for the evaluation and work up of wound cultures that provide effective and appropriate guidance for patient therapy.

Course Outline

  • Identify the optimal specimen types to be submitted for assessment of various wound infections.
      • Ideal Specimens Used to Diagnose Wound Infections
      • Types of Wound Specimens Submitted for Microbiological Processing
      • Descriptive Terms for Dermal and Epidermal Lesions and Infections
      • What type of infection is a wound involving the hair follicle that is described as a papule pierced by hair and surrounded by redness, without pus?
      • In general, what is the preferred specimen for a wound culture workup?
      • A patient presents to their physician with a wound that the physician describes as a crater-like defect with loss of the epidermis and dermis on the g...
      • Which of the following statements is not true about collecting a wound specimen for culture?
  • Define appropriate methods for wound culture collection and describe how the specimen type may impact the clinical relevance of the results.
      • Essential Aspects of Wound Culture Collection
      • Collection Methods for Various Types of Wounds
      • Necrotizing Lesions: Definitions and Specimen Collection
      • Clinical Relevance of Results of Various Wound Cultures: Do's and Don'ts
      • Which of the following describes the preferred collection method when collecting a superficial wound specimen?
      • This infection is painful and involves subcutaneous tissues. It may be due to an underlying decubitus ulcer. If suspected, it is an emergency surgical...
      • This type of necrotizing lesion is an indolent process involving the muscle and fascia; it is usually associated with trauma or surgical procedures. B...
      • A physician has a patient presenting with an open abscess on the arm of unknown origin. The patient denies any animal or human bites and has not had a...
      • A patient presents with necrotic tissue in his toe due to inadequate blood supply. During surgical debridement and amputation of the affected toe, the...
  • Outline appropriate specimen processing and plating for wound culture specimens.
      • Culture Requests Based on Wound Type
      • Processing and Media Selection: General Guidelines
      • Processing and Media Selection: Additional Information
      • Processing and Media Selection: Non-routine Requests
      • Specimen Processing: Tissue Samples
      • Which of the following wound types should not be included in an anaerobic culture?
      • Which of the following would indicate the necessity for including a broth medium in the culture preparation?
      • When should a chocolate agar be added to the minimum plating protocol?
      • A professional landscaper presents to his physician complaining of a wound on his knee that he suspects occurred after kneeling on a rose bush.The phy...
      • A 51-year-old coastal fisherman presented to his physician with cellulitis on his right arm. The physician cultured the site and sent it to microbiolo...
  • Be able to list the common pathogens isolated from wound cultures, describe their Gram stain result and appearance on routine culture media.
      • Common Organisms Causing Wound Infections
      • Common Aerobic Organisms Isolated From Wound Cultures
      • Common Anaerobic Organisms Isolated From Wound Cultures
      • Expected Gram Stains in Common Wound Infections
      • Expected Gram Stains in Common Wound Infections, continued
      • The image to the right depicts the Gram stain observed from a small white colony found only on the anaerobic culture. What is the most likely identifi...
      • A 28-year-old woman presented to her physician for a follicular wound on her foot that has progressively deteriorated over the last week and a half. T...
      • When reviewing the Gram stain from a foot wound on a 65-year-old female patient, you notice small gram-negative rods that exhibit bipolar staining. Af...
  • Understand the different strategies for the evaluation and work up of wound cultures that provide effective and appropriate guidance for patient therapy.
      • Overall Principles of Working up Wound/Abscess Cultures
      • Determining the Extent of Workup: Q Score
      • Determining the Extent of Workup Based on Number of Potential Pathogens in Culture
      • Which of the following principles concerning the workup of wound/abscess cultures is true?
      • This strategy is used to bring standardization to wound culture workups. It is based on the number of polymorphonuclear (PMN) cells compared to the nu...
      • While working up a wound culture from an arm abscess, there are enteric gram-negative rods and a moderate amount of coagulase-negative staphylococci a...
      • In your microbiology laboratory, you utilize the Q score to determine the extent of the work up performed on wound cultures. When reviewing an abscess...
  • References
      • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: This program is designed as an educational and training tool for MLS, MT, and MLT personnel, medical laboratory science students and interns, pathology residents, and practicing pathologists.
Author Information: Hallee Waye, BS, MLS (ASCP)CM, has over 10 years of experience as a medical laboratory scientist. She has clinical experience in blood bank, microbiology, chemistry, hematology, urinalysis, and coagulation. She currently works as a clinical microbiologist and MLS Program Director for the Parkview School of Medical Laboratory Science in Pueblo, CO. She obtained her bachelor’s degree in microbiology from Colorado State University, attended the Colorado Center for Medical Laboratory Science to obtain her professional certificate in medical laboratory science, and completed her master’s degree in clinical laboratory science at the University of Texas Rio Grande Valley.
Reviewer Information: Alexandru Casapu, MBA, MLS(ASCP)CM, PBTCM, has over 20 years of experience as a medical laboratory scientist, section supervisor, and laboratory manager. He is the former Director of Clinical Laboratory Technology Program at Georgia Piedmont Technical College. He is currently a Program Director at MediaLab, Inc. Alex holds BS degrees in Biology and Medical Technology from Clark Atlanta University and an MBA from the University of Georgia.

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