Wound Culture and Sensitivity Guidelines

Introduction to Wound Cultures

• The Infectious Diseases Society of America recommends ordering cultures for infected wounds to guide antibiotic selection, particularly for moderate to severe infections 1, 2
• The Infectious Diseases Society of America suggests not culturing clinically uninfected wounds unless performing infection-control surveillance 1, 2
• Cultures may be unnecessary for acute mild infections in antibiotic-naive patients, as stated by the Infectious Diseases Society of America 1, 2
• The Infectious Diseases Society of America recommends ordering blood cultures for severe infections, especially when the patient is systemically ill 1, 2

Specimen Collection and Transport

• The Infectious Diseases Society of America and the Diabetes/Metabolism Research and Reviews recommend cleansing and debriding the wound thoroughly before obtaining any specimen, with a strength of evidence based on clinical guidelines 1, 2, 3
• The Infectious Diseases Society of America suggests removing all necrotic tissue and purulent material first, as part of the debridement process 1, 2
• The Diabetes/Metabolism Research and Reviews recommend obtaining tissue from the debrided wound base using curettage or biopsy, as the preferred collection method 1, 2, 3
• Tissue specimens are superior to swabs with higher sensitivity and specificity, according to the Diabetes/Metabolism Research and Reviews 4, 3
• The Infectious Diseases Society of America recommends sending specimens promptly in sterile transport containers or appropriate transport media, to ensure accurate laboratory results 1, 2, 3

Order Components and Laboratory Processing

• The Infectious Diseases Society of America and the Diabetes/Metabolism Research and Reviews recommend including essential information such as specimen type, anatomic location, type of infection, and current antibiotic therapy, when ordering wound cultures 4, 3, 1, 2
• The Infectious Diseases Society of America suggests requesting both aerobic and anaerobic culture with antimicrobial sensitivity testing, to guide antibiotic selection 1, 2
• Traditional phenotypic culture takes 2+ days for results, while molecular/genotypic testing (PCR) can provide results within 4-6 hours with higher sensitivity, according to the Diabetes/Metabolism Research and Reviews 4

Wound Culture and Sensitivity Testing

Introduction to Wound Culture

• The Infectious Diseases Society of America recommends specifying the body site and type of wound when ordering a wound culture, such as "human bite wound, knuckle" or "diabetic foot ulcer" 5, 6, 7

Quantitative Cultures

• For certain wound types, such as burn wounds and chronic wounds, a quantitative wound culture may be specified, which measures the bacterial load (colony-forming units per gram of tissue), and must be specifically requested as not all laboratories offer this service 5, 8