Clinical Information

Wound, Abscess, Exudates: Skin and soft tissue infections can occur as a result of a break in the skin surface, or they can occur as complications of surgery, trauma, human animal, or insect bites or diseases that interrupt a mucosal or skin surface. Specimen collection is of utmost importance for these specimen types. For most open lesions and abscesses, remove the superficial flora by decontaminating the skin before collecting a specimen from the advancing margin or base. A close abscess is the specimen site of choice. Aspirate the abscess contents with a syringe. The specific anatomic site is required to establish possible contaminating flora in the area of specimen collection for appropriate reporting of culture results. For this reason, specimens should be labeled as to the specific anatomic source and to distinguish between "surface" and "deep/surgical" specimens. Do not label only as "wound". Antimicrobial susceptibility testing should be performed on pure culture isolates of pathogenic (or potentially pathogenic in special situations) bacteria grown from specimens that have been appropriately collected so as not to confuse clinically significant isolates with normal flora. Antimicrobial susceptibility testing determines the minimal inhibitory concentration (MIC) value of selected antimicrobial agents against isolated potentially pathogenic bacteria. The MIC is the lowest antimicrobial concentrations (of a series of increasing concentrations) that inhibits growth of the bacterium. For each organism-antimicrobial agent combination, the Clinical and Laboratory Standards Institute and/or the FDA on Antimicrobial Susceptibility Testing provides interpretive criteria for determining whether the MIC should be interpreted as susceptible, intermediate, nonsusceptible or resistant.