title: Rapid enzyme analysis as a diagnostic tool for wound infection: Comparison between clinical judgment, microbiological analysis, and enzyme analysis.
abstract: In clinical practice, diagnosis of wound infection is based on the classical clinical signs of infection. When infection is suspected, wounds are often swabbed for microbiological culturing. These methods are not accurate (clinical judgment in chronic wounds) or provide results after several days (wound swab). Therefore, there is an urgent need for an easy-to-use diagnostic tool for fast detection of wound infection, especially in chronic wounds. This study determined the diagnostic properties of the enzymes myeloperoxidase, human neutrophil elastase (HNE), lysozyme and cathepsin-G in detecting wound infection when compared to wound swabs. Both chronic and acute wounds of 81 patients were assessed through clinical judgment, enzyme analysis and wound swab. Three promising enzyme models for detecting wound infection were identified. A positive test was defined as: at least one enzyme positive after 30 minutes (model 1), lysozyme and HNE positive after 30 minutes (model 2), myeloperoxidase positive after 5 minutes, and HNE or lysozyme positive after 30 minutes (model 3). All models were significant (p≤0.001). There was no correlation between clinical judgment and wound swab, indicating the need for novel diagnostic systems. Enzyme analysis is fast, easy to use and superior to clinical judgment when compared to wound swabs.
authors: Department of Surgery, Medisch Spectrum Twente Hospital, Enschede, The Netherlands.
authors: Miriam H E
authors: MH
authors: Blokhuis-Arkes
authors: Department of Medical School Twente, Medisch Spectrum Twente Hospital, Enschede, The Netherlands.
authors: Marieke
authors: M
authors: Haalboom
authors: Department of Medical School Twente, Medisch Spectrum Twente Hospital, Enschede, The Netherlands.|Department of Research Methodology, Measurement and Data Analysis, University of Twente, Enschede, The Netherlands.
authors: Job
authors: J
authors: van der Palen
authors: Austrian Center of Industrial Biotechnology, Graz, Austria.
authors: Andrea
authors: A
authors: Heinzle
authors: Austrian Center of Industrial Biotechnology, Graz, Austria.
authors: Eva
authors: E
authors: Sigl
authors: Austrian Center of Industrial Biotechnology, Graz, Austria.|Department of Agrobiotechnology Institute of Environmental Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria.
authors: Georg
authors: G
authors: Guebitz
authors: Department of Surgery, Medisch Spectrum Twente Hospital, Enschede, The Netherlands.
authors: Roland
authors: R
authors: Beuk
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D056649:Cathepsin G / Q000032:analysis; D002908:Chronic Disease; D004796:Clinical Enzyme Tests; D005260:Female; D006801:Humans; D008297:Male; D008828:Microbiological Techniques; D009113:Muramidase / Q000032:analysis; D009426:Netherlands / Q000453:epidemiology; D009195:Peroxidase / Q000032:analysis; D010818:Practice Patterns, Physicians'; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D015843:Serpins / Q000032:analysis; D013048:Specimen Handling; D014945:Wound Healing / Q000187:drug effects*; D014946:Wound Infection / Q000175:diagnosis* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D015843:Serpins; C075177:SERPINB1 protein, human; D009195:Peroxidase; D009113:Muramidase; C534094:CTSG protein, human; D056649:Cathepsin G