“When the only tool in your toolbox is a hammer, all your problems begin to look like nails.”
This is an old saying from Abraham Maslow, with no interpretation necessary. Regardless of the technological advances in lab diagnostics, the “hammer” in the toolbox of many providers in an attempt to identify the bacteria present in a patient’s wound, remains the culture.
Resistant to Change
Even though advanced genetic technologies which can target the specific needs of wound care patients, exist today, there is still a segment of the health care community, for whatever reason, who insist on culturing wounds. I am not here to tell anyone they are wrong or get into a mud-slinging contest with a great wound provider. Over the last decade, it has become well known the large mass of bacterial material present within a wound (biofilm) is a primary and universal reason for the lack of timely healing in chronic wounds. We know that most wounds are polymicrobial in nature. With the existence of this “community” of coexisting and cooperative microorganisms present, it is now known culturing will not reveal all of the organisms present.
Telling the Whole Story
The confidence that the culture will provide an accurate picture of the pathogens involved is low due to several factors.
To begin only a small percentage (approx. 2-4%) of all known bacterial species can be routinely cultured. Additionally, only a small subset of these will grow within a 24 hour period prescribed for most cultures. Another limitation is that yeast, including Candida species, are rarely identified in cultures. Finally, some species love to grow in the lab and bully other species to the point they are not identified.
Regardless of what method a provider prefers, one cannot argue the point intelligently that, “Knowledge is power.” Back in 2012, one company was trying to drag providers kicking and screaming into the world of using DNA and RNA to identify pathogens. Today, one has to have their head in the ground not to realize the value of PCR testing for wounds. Identifying all of the pathogens involved with the patient’s clinical findings and also being able to help determine which antibiotic would be the most effective, is our job as a PCR laboratory.
How ILDP Can Help
We are here to partner with the provider to give the patient the quickest most effective and appropriate treatment available while being attentive to cost to the patient. Quick and accurate results, identifying all the pathogens present, as well as identifying a patient’s antibiotic resistance is our goal to help providers treat their patients in the most efficacious manner possible.
Change is challenging. We are here to make using PCR testing as painless as possible. Please reach out with any questions or issues. We do appreciate the business from all of our clients and remain dedicated to helping in any way we can. Thank you for your trust in us.
President/CEO Industry Lab Diagnostic Partners