Agreement Between Two Fluorescence Light Devices in Antimicrobial Control in Infected Complex Wounds

The portable MolecuLight i:X ® device is able to detect microbial load above 10^4 CFU/g in a wound through fluorescence, allowing control of the use of antiseptics, dressings, and antibiotics in these lesions. Due to the high cost of this equipment, access is limited, making it necessary to evaluate other instruments. To compare the agreement of autofluorescence observed in complex wounds with concomitant use of the MolecuLight i:X® (ML) devices and a common fluorescence light lamp (CL) with 100 LED and 395 nm associated with a 12-megapixel camera. Observational, retrospective, single-center study in a tertiary-level general hospital, within the routine of infectious diseases for the control of complex wounds with suspected infection. The sample consisted of 27 participants, with 33 wounds. Analyses performed: image records using both devices, clinical and epidemiological data, culture results of wound samples. The method used to obtain cultures was dermal aspirative puncture by needle, guided by the autofluorescence record detected using the MolecuLight i:X ® device. Observed and expected agreements and the AC1 coefficient were calculated to evaluate the strength of agreement between the MolecuLight i:X® and the common fluorescence light lamp associated with a 12-megapixel camera. Regarding the topography in which autofluorescence was detected, agreement was classified as total, partial, or absent. The analysis was applicable to cases in which autofluorescence was detected as positive. In total, fluorescences with ML and CL were totally overlapping, present in 14.8% of the sample. In partial, fluorescences with ML and CL were partially overlapping, present in 85.2% of the sample. High agreement (AC1=0.846) was found regarding autofluorescence results (positive or negative), and moderate to substantial agreement in the case of color agreement analysis. It was not possible to establish agreement between autofluorescence color and the organism isolated in culture. The most frequently isolated organisms were Staphylococcus aureus and Escherichia coli, with the others being mostly Gram-negative bacilli. It seems possible to use the common fluorescence light lamp in complex wounds to rationalize antimicrobial use (antiseptics and antibiotics).