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Culture & Sensitivity, Aerobic bacteria Tissue / Biopsy (Manual method)

Biopsy
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Report in 72Hrs

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No Fasting Required

Details

Identifies bacteria & antibiotic susceptibility.

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Culture & Sensitivity Aerobic bacteria Tissue / Biopsy (Manual method)

  • Why is it done?
    • Identifies aerobic bacterial pathogens present in tissue or biopsy specimens collected from infected or suspected infected sites
    • Determines the antibiotic susceptibility profile of isolated bacteria to guide targeted antimicrobial therapy
    • Diagnostic indications include: suspected wound infections, abscess drainage, bone or joint infections, soft tissue infections, surgical site infections, skin infections, and biopsy specimens from various organ systems
    • Typically performed when patients present with signs and symptoms of bacterial infection at the biopsy or tissue collection site, such as fever, localized pain, swelling, erythema, or purulent drainage
    • Essential for cases of immunocompromised patients, diabetics with tissue infections, post-surgical complications, or when empiric antibiotic therapy has failed
  • Normal Range
    • Normal result: No aerobic bacterial growth / Negative
    • Interpretation: A negative culture indicates absence of pathogenic aerobic bacteria in the tissue sample, suggesting either no active bacterial infection, effective antimicrobial therapy, or proper wound healing
    • Abnormal result: Positive with bacterial isolate identification and colony count quantification
    • Colony quantification expressed as: Colony Forming Units per milliliter (CFU/mL) or reported as light, moderate, heavy, or significant growth
    • Results reported with specific bacterial identification (genus and species) and comprehensive antibiotic susceptibility profile
    • Susceptibility interpretation: Susceptible (S), Intermediate (I), or Resistant (R) to tested antibiotics, with Minimum Inhibitory Concentration (MIC) values where applicable
    • Contaminant flora may be reported separately when identified; clinical correlation required to distinguish true pathogens from contaminating organisms
  • Interpretation
    • Single isolate (>10^5 CFU/mL): Typically represents true pathogenic infection, especially from normally sterile tissue sites. Susceptibility results guide specific antibiotic selection
    • Multiple isolates (polymicrobial growth): Indicates mixed bacterial infection common in wound infections, abscesses, or GI-sourced infections. Broad-spectrum antimicrobial coverage may be necessary pending susceptibilities
    • Light growth (<10^3 CFU/mL): May represent early infection, contamination, or colonization. Clinical correlation with patient symptoms and specimen quality is essential
    • Resistant organisms: Multidrug-resistant organisms (MRSA, ESBL-producing Enterobacteriaceae, Pseudomonas) require alternative antimicrobial strategies. Infectious disease consultation may be warranted
    • Fastidious organisms: Organisms like Haemophilus or Neisseria may require special media. Manual culture methods may detect organisms missed by automated systems
    • Factors affecting results: Specimen quality and appropriate collection techniques, delay in processing, prior antimicrobial therapy, contamination during collection, and adequacy of sample size significantly impact culture outcomes and sensitivity
    • Clinical significance: Positive culture with documented susceptibilities confirms bacterial infection diagnosis and enables targeted antimicrobial therapy, reducing complications and treatment failures
  • Associated Organs
    • Primary systems involved:
    • Integumentary system: Skin and subcutaneous tissues; cellulitis, abscesses, diabetic foot ulcers, surgical site infections, decubitus ulcers
    • Musculoskeletal system: Bone and joint tissues; osteomyelitis, septic arthritis, orthopedic prosthetic infections
    • Respiratory system: Lung tissue biopsies; pulmonary infections, empyema, pneumonia with tissue involvement
    • Gastrointestinal system: Bowel, liver, pancreatic tissues; peritonitis, appendicitis, bowel perforation-related infections
    • Urinary system: Bladder, kidney, prostate tissues; chronic pyelonephritis, bladder infections with tissue involvement
    • Cardiovascular system: Heart valve, vessel tissue biopsies; bacterial endocarditis, vascular graft infections
    • Diseases and conditions diagnosed:
    • Acute and chronic wound infections, biofilm-associated infections, prosthetic material infections, nosocomial and community-acquired infections, immunocompromised host infections
    • Potential complications:
    • Delayed diagnosis leading to systemic spread and sepsis, tissue necrosis and gangrene, inadequate wound healing, chronic osteomyelitis development, antibiotic resistance propagation, treatment failure and recurrent infections
    • Life-threatening complications: Septic shock, multi-organ failure, bacteremia, and fatal outcomes if appropriate targeted therapy is not initiated timely
  • Follow-up Tests
    • Repeat culture and sensitivity testing: Recommended 48-72 hours post-treatment initiation to document sterilization of wound or tissue, and to confirm antimicrobial efficacy
    • Extended antibiotic susceptibility panel: For resistant isolates, advanced testing (E-test, broth microdilution) may determine MIC values for dose optimization
    • Blood cultures: Indicated if clinical signs suggest bacteremia or sepsis accompanying the tissue infection
    • Complete blood count (CBC): Monitors for leukocytosis, left shift, or sepsis-induced thrombocytopenia reflecting infection severity
    • Comprehensive metabolic panel: Assesses renal and hepatic function, electrolytes, and lactate levels indicating sepsis and treatment response
    • Inflammatory markers: C-reactive protein (CRP) and procalcitonin levels help assess infection burden and treatment response monitoring
    • Imaging studies: CT scan, MRI, or ultrasound to assess tissue involvement extent, abscess formation, and surgical drainage necessity
    • Anaerobic culture and sensitivity: If indicated by specimen source (deep wounds, abscesses from GI tract), detect anaerobic co-pathogens
    • Fungal and mycobacterial cultures: Indicated for immunocompromised patients or when clinical presentation suggests atypical infections
    • Molecular testing (PCR): For rapid identification of specific pathogens or resistance determinants when conventional culture results are delayed
    • Histopathology examination: Complements culture results; assesses inflammation degree, necrosis, and guides surgical intervention necessity
    • Monitoring frequency: Weekly cultures until negative results confirm sterilization; ongoing surveillance for recurrence in chronic osteomyelitis or biofilm-associated infections
  • Fasting Required?
    • Fasting requirement: NO
    • This is a tissue/biopsy culture test requiring specimen collection via biopsy or surgical procedures; fasting is not related to test performance
    • Pre-collection patient preparation:
    • If biopsy procedure requires sedation or anesthesia, fasting may be mandated per procedural guidelines; follow specific instructions provided by the healthcare facility
    • Typical NPO (nothing by mouth) requirement: 6-8 hours before biopsy if general or regional anesthesia planned
    • Medications to avoid or continue:
    • Discontinue anticoagulants (warfarin, dabigatran) 3-5 days before biopsy; discuss bridging anticoagulation needs with provider
    • Hold antiplatelet agents (aspirin, clopidogrel) 5-7 days pre-procedure per institutional protocol to minimize bleeding risk
    • Discontinue NSAIDs 3-5 days before procedure due to increased bleeding risk
    • Continue regular medications (antihypertensives, diabetes medications) unless specifically instructed otherwise by the procedure provider
    • Avoid herbal supplements (garlic, ginger, ginkgo, St. John's Wort) that may increase bleeding; discontinue 1-2 weeks pre-procedure
    • Specimen collection requirements:
    • Use sterile technique during tissue collection; avoid contamination with skin flora or environmental bacteria
    • Place specimen in sterile container without formalin (which is bactericidal); 1-2 grams of tissue required for adequate culture
    • Minimize time between collection and processing; transport at room temperature within 2 hours to optimize organism recovery
    • For wound cultures, avoid superficial swabbing; deep tissue sampling provides better diagnostic yield and accurate pathogen identification

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