The Use of Pathogen-Detection Technologies
Effective therapeutic options in wound treatment remain one of the most prominent challenges in medical practice. More importantly, biofilms in chronic wounds have been incriminated in the development of chronic wound pathologies. Since these biofilms house polymicrobials that are significantly resistance to a broad range of antibiotics and wound therapies, the resolution of these medical challenges lies in the utilization of reliable pathogen detection technologies.
Given the labor and time constraints associated with culturing techniques, pathogen specific molecular methodologies such as universal molecular pathogen detection techniques such as bacterial tag-encoded FLX amplicon pyrosequencing (bTEFAP) and fungal tag-encoded FLX amplicon pyrosequencing (fTEFAP) as well as quantitative polymerase chain reaction (qPCR; have gained prominence in clinical detection of pathogens (Leake et al. , 2009). ii) Pathology of the Wound Infections The development of biofilms composed of polymicrobial populations attached on the surface forms loose extracellular molecular structures.
This development initiates a parasitic relationship between the host and the parasite leading to inflammation and chronicity. Studies have shown that these biofilms comprise of both bacterial and fungal species hence making wound treatment and care rather difficult (Leake et al. , 2009; Jain et al. , 2007). One of the main symptoms of C. albicans infection is red or inflamed skin surrounding the wound. iii. How the diagnostic tool works Individual qPCR assays detect specific pathogens present in the wound.
Using specific qPCR microbes, samples from the wound can be assayed for the presence of pathogens corresponding to the probe. Most clinical laboratories rely on custom wound pathogen PCR panel to identify polymicrobials, compute the percentage composition of the species in the colony, and test for antimicrobial resistance (Leake et al. , 2009). On the other hand, fTEFAP and bTEFAP utilize taxonomic and ecological principles in the identification of unknown microorganisms on the basis of their unique genetic compositions.
Small fungal or bacterial subunit ribosomes are amplifies to determine the identity of the microbe (Dowd et al. , 2008). iv. The outcome of new pathogen detection technologies As opposed to culturing techniques, qPCR using C. albicans specific probes yields diagnostic results in a very short time (within 24 hours). Both diabetic foot cancer and traumatic wounds show a high C. albicans prevalence. bTEFAP and fTEFAP identify not only the prevalence of C. albicans, but also other pathogens which cannot be identified using qPCR and culturing techniques.
qPCR, bTEFAP and fTEFAP are highly sensitive molecular pathogen detection wounds. Data suggests that C. albicans is one of the most prominent contributors to biofilm communities and therefore, the development of chronic wounds (Leake et al. , 2009). The detection of both fungal and bacterial communities aids in improving diagnosis. v. Impacts on Nursing Early recognition, appropriate diagnosis, and therapeutic management of any cutaneous disorder/disease hasten the wound healing process. qPCR, bTEFAP and fTEFAP diagnostic tools ensure that diagnosis is achieved with the 24 hour period.
The detection of both bacterial and fungal populations in the biofilms influences dressing decisions. Knowledge of the underlying etiology enables nurses to develop strategies that optimize the wound environment and facilitate a faster healing process (Craig, 2008). Accurate diagnosis also acts as a guide to administering the appropriate antibiotics or therapies. References Craig, L. B. (2008). Dressing Decisions, In “Chronic Wound Care: A Clinical Source Book for Health Care Professionals, (4th ed), HMP Communications Dowd, S. E. , Wolcott, R. D. , Sun, Y. (2008).
Polymicrobial nature of chronic diabetic foot ulcer biofilm infections determined using bacterial tag encoded FLX amplicon pyrosequencing (bTEFAP). PLoS ONE 2008; 3: 10, e3326 Leake, J. , Dowd, S. , Wolcott, R. , & Zischkau, A. (2009). Identification of yeast in chronic wounds using new pathogen-detection technologies, Journal of Wound Care, 18(3), 103 Jain, N. , Kohli, R. , Cook, E. (2007). Biofilm formation by and antifungal susceptibility of Candida isolates from urine, Appl Environ Microbiol, 73: 6, 1697-1703
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