Evaluation of a rapid multispectral autofluorescence device for detection and classification of bacterial infections in wounds reported to a tertiary hospital in Delhi.

BACKGROUND

Antimicrobial resistance is a growing global health challenge, amplified by the empirical use of broad-spectrum antibiotics in wound management. Conventional microbial cultures require 48-72 hours for pathogen identification, delaying targeted therapy and promoting inappropriate antibiotic use.

OBJECTIVE

This study evaluated the diagnostic performance of the Illuminate® multispectral autofluorescence imaging device for rapid detection and Gram-type classification of wound infections, compared with standard culture method.

METHODS

A cross-sectional study was conducted over six months at a tertiary hospital in Delhi, among 163 patients with fresh open wounds. The Illuminate® device captured autofluorescence images (365-415 nm) and provided Gram-type classification within two minutes. Parallel samples underwent Gram staining and aerobic culture according to Clinical and Laboratory Standards Institute guidelines. Diagnostic accuracy metrics were computed using STATA v17.

RESULTS

The Illuminate® device demonstrated strong diagnostic performance, showing an overall accuracy of 81.6% for Gram-negative bacteria (Cohen's κ = 0.6213, p < 0.01) and 86.5% for Gram-positive bacteria (κ = 0.5916, p < 0.01).

CONCLUSION

The Illuminate® device offers rapid, reagent-free bacterial classification with high specificity for both Gram types, but sensitivity for Gram-positive bacteria was only moderate; used as an adjunct to, rather than a replacement for, culture, it may support earlier antibiotic optimization and advance antimicrobial stewardship in wound care.