Quantitation of Pseudomonas aeruginosa in wound biopsy samples: from bacterial culture to rapid ‘real-time’ polymerase chain reaction

Although effective topical antimicrobial chemotherapy and early excision of burn wounds have significantly reduced the occurrence of invasive burn wound infections, sepsis is still a major problem [ 1 , 2 , 3 ]. The risk of septicaemia increases in proportion to the degree of cutaneous infection [ 4 , 5 , 6 ]. Many investigators have reported [ 6 , 7 , 8 , 9 , 10 , 11 ] that quantitative biopsy culture was the best method for early detection of sepsis. Heininger et al [ 12 ] stressed that only 4-12% of blood cultures is found positive. Conversely, McManus et al [ 13 ] reported in 1987 that high tissue counts did not necessarily indicate invasion, and that the principal value of quantitative biopsy culture was the demonstration of the predominant burn wound flora. Even so, when sepsis ensues, while awaiting the results of blood cultures, a knowledge of the organisms that colonize a burn wound can facilitate prompt and appropriate antibiotic treatment that is based on the expected sensitivity of the identified germs, rather than initiating a purely empirical therapy. There is need for qualitative and quantitative tests that are more rapid than bacterial culture.