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Overcoming Culture Limitations: Molecular Testing for Skin and Soft Tissue Infections

Posted By Michelle Altrich, Tuesday, July 11, 2017

Recent developments in molecular technology have given us new tools to aid in the diagnosis of chronic skin and soft tissue infections (SSTIs).  Amid growing discussions around how molecular testing can help wound care, Target Enriched Multiplex Polymerase Chain Reaction – a PCR amplification technology to detect multiple targets simultaneously – has emerged as a solution to significantly aid in the identification of key bacterial pathogens responsible for non-healing SSTIs.

Culture has been the standard method for diagnosis; however, culture has limits.  Despite optimal specimen collection, culture bias and false negative results can be a real problem.  Commensals may overgrow cultures and obscure the presence of pathogens.  Some bacterial species will flourish under culture conditions, while others won’t be detected.  Biofilms, an ongoing issue for chronic wound care, are inherently polymicrobial — culture can’t identify these pathogens effectively. So it’s not that culture is wrong, it is incomplete.   Culture limits our understanding of the true microbial composition of SSTIs. What pathogens are we missing?  What pathogens are we not treating?

Molecular testing adds improved depth of information, and the advantages over culture are several-fold. Turnaround time is one of the most critical.  PCR results are available in less than a day.  Ongoing antibiotic treatment does not interfere with molecular detection, and bacterial pathogens that are difficult to grow in culture are detected reliably by molecular techniques.

Based on the “IDSA Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections” efforts should be focused on “Rapid and specific diagnostic assays for identification of microbes”.  Molecular methods meet many of the requirements to fulfill this need.

Viracor offers a same day TEM-PCR panel* that detects common bacterial pathogens—offering clinicians a faster, more sensitive and comprehensive assessment of complex bacterial infections within a wound.  For a complete list of pathogens, please visit us online. Ruling in and out the presence of specific bacterial infections in SSTIs is clinically significant.  It reduces unnecessary antibiotic utilization and costs, and increases patient satisfaction—resulting in greater clinical value and effectiveness.

*Same day (within 8 to 12 hours of receiving specimen), Monday through Saturday.

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