{"id":289,"date":"2023-09-16T22:19:58","date_gmt":"2023-09-16T21:19:58","guid":{"rendered":"https:\/\/microregistrar.com\/?p=289"},"modified":"2023-09-16T22:19:58","modified_gmt":"2023-09-16T21:19:58","slug":"smi-note-investigation-of-swabs-from-the-skin-and-superficial-soft-tissue-infection","status":"publish","type":"post","link":"https:\/\/microregistrar.com\/?p=289","title":{"rendered":"SMI (note): Investigation of swabs from the skin and superficial soft tissue infection"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\" id=\"specimen\">Specimen<\/h2>\n\n\n\n<p>Advice for the users:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A sample of pus\/ exudate is preferred over a swab.<\/li>\n\n\n\n<li>If a small amount of fluid is available, put it in an appropriate transport medium to prevent drying.<\/li>\n\n\n\n<li>Put the bacterial and fungal swabs in an appropriate transport medium.<\/li>\n\n\n\n<li>Send samples from where the infection is \u2013 sending dry crust or dead tissue or a superficial swab from an ulcer is not useful.<\/li>\n\n\n\n<li>For an ulcer \u2013 remove all the debris, clean the wound with normal saline, and take a biopsy\/needle aspirate from the edge of the ulcer. Alternatively, irrigate the area under the ulcer margin with 1ml sterile 0.85% normal saline (no preservative), massage the ulcer margin, irrigate again with 1ml, massage again and aspirate 0.25ml fluid. Send for culture and sensitivity.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"safety\">Safety<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Containment level 2.<\/li>\n\n\n\n<li>If performing an aerosol-generating procedure \u2013 perform it in a safety cabinet.<\/li>\n\n\n\n<li>If suspecting a category 3 organism (either notified or from clinical details) \u2013 E.g. Bacillus anthracis (exposure to animal hide, bioterrorism event etc), perform the processing of specimen in containment level 3, in a microbiological safety cabinet.<br>All work on suspected isolates of C. diphtheriae which is likely to generate aerosols must be performed in a safety cabinet.<br>A medical microbiologist must be informed of all suspected isolates of C. diphtheria as soon as possible. Isolate should be referred to the reference lab.<\/li>\n\n\n\n<li>PHE and infection control should be notified as per local\/national policy.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"processing\">Processing<\/h2>\n\n\n\n<p>Gram stain \u2013 usually not done unless deep-seated pus from a normally sterile site<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"plate-selection\">Plate selection<\/h4>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th>CONDITION<\/th><th>PLATES<\/th><\/tr><\/thead><tbody><tr><td>All clinical conditions<\/td><td>Blood agar<br>CLED\/MacConkey agar<\/td><\/tr><tr><td>Wound swab<\/td><td>Selective anaerobic agar with metronidazole disc<\/td><\/tr><tr><td>Pus<\/td><td>Fastidious anaerobic, cooked meat broth;<br>then Subculture to blood agar.<\/td><\/tr><tr><td>Cellulitis in children<br>Human bite<\/td><td>Chocolate agar with bacitracin (for Haemophilus and fastidious organisms)<\/td><\/tr><tr><td>Burn patients,<br>Immunocompromised patients,<br>Paronychia (Will need a layer of oil to culture for mould),<br>Intertrigo,<br>Diabetic patient<\/td><td>Sabouraud agar (Yeast, Moulds)<\/td><\/tr><tr><td>Suspecting cutaneous diphtheria<br>(foreign travel &lt;10 days, non-healing ulcer)<\/td><td>Hoyle\u2019s tellurite agar<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><strong>Anaerobic agar\/broths \u2013 incubate for five days, may need longer if suspecting Actinomyces.<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"which-antibiotics-to-test\">Which antibiotics to test<\/h2>\n\n\n\n<p>Release antibiotics based on<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>the information provided in the clinical details (previously used antibiotic, intended antibiotic, any allergy or intolerance, any failure to treatment etc),<\/li>\n\n\n\n<li>likelihood of the organism being a pathogen (may suppress antibiotics if the organism is likely to represent colonising flora)<\/li>\n\n\n\n<li>patient&#8217;s age or status (e.g tetracycline is contraindicated in children and in pregnancy, use of cephalosporins, clindamycin, and ciprofloxacin should be done with caution in older patients due to the risk of C difficile associated diarrhoea)<\/li>\n\n\n\n<li>Preexisting microbiology (may not use ciprofloxacin in a patient with previous MRSA or C difficile diarrhoea)<\/li>\n\n\n\n<li>local and national policy.<\/li>\n\n\n\n<li>Consider releasing antibiotics that are resistant (good practice)<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th>ORGANISM<\/th><th>PRIMARY TEST PANEL<\/th><th>SUPPLEMENTARY TEST PANEL<\/th><th>NOTE<\/th><\/tr><\/thead><tbody><tr><td>Staph aureus<\/td><td>-Cefoxitin or oxacillin (screen for flucloxacillin)<br>-Erythromycin\/Clarithromycin<br>-Tetracycline (do not release in children\/pregnant patients)<\/td><td>-Clindamycin (consider dissociative resistance, if erythromycin R),<br>-Co-trimoxazole,<br>-Daptomycin,<br>-Fusidic acid,<br>-Gentamicin,<br>-Linezolid,<br>-Mupirocin,<br>-Penicillin,<br>-Rifampicin,<br>-Teicoplanin,<br>-Vancomycin<\/td><td><\/td><\/tr><tr><td>Pyogenic Streptococci<\/td><td>\u2013 Erythromycin\/ Clarithromycin<br>\u2013 Penicillin,<br>\u2013 Tetracycline (do not release in children\/pregnant patients)<\/td><td>-Clindamycin<br>-Co-trimoxazole<br>-Linezolid<br>-Vancomycin<\/td><td><\/td><\/tr><tr><td>Enterobacteriaceae<br>(from clean surgical<br>sites \u2013 only release antibiotic if evidence of infection)<\/td><td>Ampicillin (or Amoxicillin)<br>Cefpodoxime (Screen for ESBL)<br>Co-amoxiclav<br>Gentamicin<\/td><td>-Amikacin<br>-Aztreonam<br>-Cefotaxime (or Ceftriaxone)<br>-Ceftazidime<br>-Cefuroxime<br>-Ciprofloxacin<br>-Co-trimoxazole<br>-Ertapenem<br>-Meropenem (or Imipenem)<br>-Piperacillin\/Tazobactam<br>-Temocillin<\/td><td>Test cefpodoxime resistant strains for ESBL and reduced susceptibility to carbapenems.<br><br>Use an interpretative comment suggesting that it may represent colonising flora.<br><br>Pure growth may have a higher chance of being significant.<\/td><\/tr><tr><td>Enterobacteriaceae<br>from sites prone to<br>colonisation (eg<br>ulcers)<\/td><td><\/td><td>-Amikacin<br>-Ampicillin (or Amoxicillin)<br>-Aztreonam<br>-Cefpodoxime<br>-Cefuroxime<br>-Ciprofloxacin<br>-Ceftazidime<br>-Cefotaxime (or Ceftriaxone)<br>-Co-amoxiclav<br>-Cotrimoxazole<br>-Ertapenem<br>-Gentamicin<br>-Meropenem (or Imipenem)<br>-Piperacillin\/Tazobactam<br>-Temocillin<\/td><td>These are often considered colonising flora, and a sensitivity test is not undertaken. If a sensitivity test is being done, include co-amoxiclav and cefpodoxime. If cefpodoxime resistant test for ESBL. If either of them is positive, check for reduced susceptibility to carbapenems.<br><br>Use an interpretative comment suggesting that it may represent colonising flora.<\/td><\/tr><tr><td>Pseudomonas<\/td><td><\/td><td>-Amikacin<br>-Ceftazidime<br>-Ciprofloxacin<br>-Gentamicin<br>-Meropenem (or Imipenem)<br>-Piperacillin\/Tazobactam<\/td><td>Use an interpretative comment suggesting that it may represent colonising flora.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"target-organisms\">Target organisms<\/h2>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th>CONDITION<\/th><th>COMMON ORGANISMS<\/th><th>NOTE<\/th><\/tr><\/thead><tbody><tr><td>Cellulitis and erysipelas<\/td><td>\u2013 \u03b2-haemolytic streptococci (including Streptococcus pyogenes),<br>\u2013 S. aureus.<\/td><td>Cellulitis involves the deeper layers of the skin and subcutaneous tissues.<br>Erysipelas involves the upper dermis and superficial lymphatic system<\/td><\/tr><tr><td>Wound infection<\/td><td>\u2013 \u03b2-haemolytic streptococci (including Streptococcus pyogenes),<br>\u2013 S. aureus,<br>\u2013 Bacteroides species<br>\u2013 anaerobic cocci<br>\u2013 Bacillus cereus (especially after trauma or orthopaedic surgery)<br>\u2013 Enterobacterales<\/td><td><\/td><\/tr><tr><td>Ecthyma gangrenosum<\/td><td>\u2013 Pseudomonas aeruginosa<br>\u2013 haematogenous dissemination of fungal infection (e.g. Candida species, Aspergillus, Fusarium and Mucorales \u2013 especially in immunocompromised\/neutropenic patients)<br>\u2013 Stenotrophomonas maltophilia<\/td><td>a focal skin lesion characterised by haemorrhage, necrosis<br>and surrounding erythema<\/td><\/tr><tr><td>Impetigo<\/td><td>Bullous impetigo:<br>\u2013 S. aureus.<br>Nonbullous impetigo:<br>-Lancefield Group A streptococci,<br>\u2013 S. aureus,<br>\u2013 Lancefield Groups C and G Streptococci<\/td><td>a superficial, intra-epidermal infection producing erythematous lesions that<br>may be bullous or nonbullous.<\/td><\/tr><tr><td>Erythrasma<\/td><td>\u2013 Corynebacterium minutissimum<\/td><td>chronic, superficial skin infection of the stratum corneum- fine, scaly, reddish-brown plaques usually in the axillae and are often misdiagnosed as a mycotic infection<\/td><\/tr><tr><td>Superficial mycoses<\/td><td>\u2013 Dermatophytes<br>\u2013 Candida species<br>\u2013 Lipophilic yeasts<\/td><td><\/td><\/tr><tr><td>Paronychia<\/td><td>\u2013 S. aureus<br>\u2013 Lancefield Group A streptococci<br>\u2013 yeasts<br>\u2013 anaerobic bacteria<\/td><td>Infection of the nail fold.<\/td><\/tr><tr><td>Folliculitis<\/td><td>\u2013 S. aureus.<br>\u2013 Pseudomonas aeruginosa (hot tub folliculitis, after exposure to swimming pool\/whirlpools),<br>\u2013 Candida spp. (after prolonged antibiotic or steroid treatment),<br>\u2013 Malassezia furfur (diabetes, steroid, granulocytopenia)<\/td><td>infection and inflammation of a hair follicle<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"necrotising-infections\">Necrotising infections<\/h4>\n\n\n\n<p>In these cases, a superficial swab may not be the best specimen. A deeper specimen could be better.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th>CONDITION<\/th><th>ORGANISMS<\/th><th>NOTES<\/th><\/tr><\/thead><tbody><tr><td><strong>Meleney\u2019s progressive synergistic gangrene<\/strong><\/td><td>\u2013 S. aureus,<br>\u2013 streptococci,<br>\u2013 Enterobacterales,<br>\u2013 Pseudomonads,<br>\u2013 Anaerobic Gram-negative bacilli.<\/td><td>a burrowing lesion or chronic<br>gangrene of the skin usually following abdominal operations and results from mixed infections<\/td><\/tr><tr><td><strong>Gas gangrene<\/strong><\/td><td>\u2013 Clostridium perfringens<br>\u2013 other Clostridium species<\/td><td>a necrotising process associated with systemic signs of toxaemia, clinical shock, leakage of serosanguinous fluid, tissue necrosis and gas is present in the tissues. It often follows traumatic injuries such as penetrating wounds or crush injuries.<\/td><\/tr><tr><td><strong>Fournier\u2019s gangrene<\/strong><\/td><td>\u2013 Non-sporing anaerobes<br>\u2013 Enterobacterales<br>\u2013 Streptococci<br>\u2013 Clostridium species<\/td><td>infection in the pelvic and scrotal areas are common causes of gangrene in ischaemic and diabetic limbs.<\/td><\/tr><tr><td>Spontaneous gangrene<\/td><td>\u2013 C. perfringens<br>\u2013 Clostridium septicum<\/td><td>most commonly seen in patients with colonic carcinoma, leukaemia or neutropenia<\/td><\/tr><tr><td>Actinomycosis<\/td><td>-Actinomyces species<\/td><td>chronic suppurative infection with abscess formation, fistula, sulphur granules (micro-colonies of<br>Actinomyces species); usually seen in jaw, chest or abdomen,<\/td><\/tr><tr><td>Necrotising fasciitis<\/td><td>-Group A streptococcus,<br>-Polymicrobial with anaerobes.<\/td><td>Infection primarily affects the<br>subcutaneous fat and superficial fascia of muscles and often the overlying soft tissues.<\/td><\/tr><tr><td>Myositis<\/td><td>\u2013 S aureus<br>\u2013 Polymicrobial<br>\u2013 Fungi, viruses etc<\/td><td>inflammation of the<br>muscle which may be caused by bacterial, fungal or parasitic infection or non-infectious causes.<\/td><\/tr><tr><td>Mycetoma<\/td><td><strong>Eumycetoma (commonest form; caused by moulds):<\/strong><br>\u2013 Acremonium species,<br>\u2013 Leptosphaeria senegalensis,<br>\u2013 Madurella grisea,<br>\u2013 M. mycetomatis,<br>\u2013 Scedosporium (Pseudallescheria) apiospermum,<br>\u2013 Pyrenochaeta romeroi,<br>\u2013 Curvularia species,<br>\u2013 Exophiala jeanselmei,<br>\u2013 Phialophora verrucosa.<br><strong>Actinomycetoma:<\/strong><br>\u2013 Actinomadura species<br>\u2013 Nocardia species<br>\u2013 Streptomyces species<br>\u2013 Madurella species<\/td><td>chronic suppurative infection with abscess formation, fistula, sulphur granules (micro-colonies of<br>Actinomyces species); usually seen in the jaw, chest or abdomen,<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"abscess\">Abscess<\/h4>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th>CONDITION<\/th><th>ORGANISMS<\/th><th>NOTE<\/th><\/tr><\/thead><tbody><tr><td>Carbuncles, furuncles, cutaneous abscess<\/td><td>Staph aureus (commonest)<\/td><td><\/td><\/tr><tr><td>Abscess in IVDU<\/td><td>\u2013 oral streptococci<br>\u2013 Streptococcus anginosus group<br>\u2013 Fusobacterium nucleatum<br>\u2013 Prevotella species<br>\u2013 Porphyromonas species<br>\u2013 S. aureus<br>\u2013 Clostridium species<br>\u2013 Bacillus anthracis (contaminated heroin)<\/td><td><\/td><\/tr><tr><td>Scalp abscess<\/td><td>\u2013 Anaerobes<br>\u2013 Polymicrobial with anaerobes:<br>\u03b2-haemolytic streptococci,<br>\uf0b7 S. aureus,<br>\uf0b7 Enterobacteriaceae,<br>\uf0b7 enterococci,<br>\uf0b7 coagulase-negative staphylococci,<\/td><td>a complication of electronic monitoring with fetal scalp electrodes during labour<\/td><\/tr><tr><td>Kerion<\/td><td>dermatophytes<\/td><td>a pustular folliculitis of adjacent hair follicles, creating densely inflamed<br>areas of the scalp<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"other\">Other<\/h4>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th>CONDITION<\/th><th>ORGANISM<\/th><th>NOTES<\/th><\/tr><\/thead><tbody><tr><td>Burn<\/td><td>\u2013 S. aureus,<br>\u2013 \u03b2-haemolytic streptococci,<br>\u2013 pseudomonads, especially Pseudomonas aeruginosa,<br>\u2013 Acinetobacter species<br>\u2013 Bacillus species,<br>\u2013 Enterobacteriaceae,<br>\u2013 filamentous fungi, e.g., Fusarium species and Aspergillus species,<br>\u2013 Candida albicans, non- albicans Candida species and other yeasts,<br>\u2013 coagulase-negative staphylococci.<\/td><td><\/td><\/tr><tr><td>Bite wounds<\/td><td>\u2013 Pasteurella multocida<br>\u2013 S. aureus<br>\u2013 \u03b1-haemolytic streptococci<br>\u2013 streptococcus anginosus group<br><br><strong>Other organisms-<br>\u2013 Anaerobes (including Bacteriodes species and Fusobacteria)<br>\u2013 Capnocytophaga species<br>\u2013 Eikenella corrodens<br>\u2013 Haemophilus species<br>\u2013 coagulase-negative<\/strong>&nbsp;staphylococci<br>\u2013 Streptobacillus moniliformis<br>\u2013 Staphylococcus intermedius<br>\u2013 Weeksella zoohelcum,<br>\u2013 Actinobacillus species and<br>\u2013 Neisseria canis<\/td><td>Capnocytophaga canimorsus is associated with dog bites and causes septicaemia, particularly in patients with asplenia or underlying hepatic disease.<br><br>Streptobacillus moniliformis is associated with rat bites, and diagnosis is confirmed by culturing the organism from blood or joint fluid.<br><br>Insect bite \u2013 secondary Group A streptococcus and S. aureus infection<\/td><\/tr><tr><td>Erysipeloid<\/td><td>Erysipelothrix rhusiopathiae<\/td><td>Uncommon nonsuppurative cellulitis painful purplish areas of inflammation with erythematous advancing edges in hand\/fingers.<br>An occupational disease of fishermen, fish handlers, butchers and<br>abattoir workers.<\/td><\/tr><tr><td>water-related wounds<\/td><td>Aeromonas and<br>non-cholera Vibrio species<br>Edwardsiella tarda and pseudomonads<\/td><td>swimming in fresh or saltwater\/ environmentally contaminated wounds, or from fishing or shellfish inflicted injuries\/ therapeutic use of leeches<\/td><\/tr><tr><td>Staph aureus \u2013 PVL producers<\/td><td>S aureus<\/td><td>Recurrent or persistent skin infection in healthy individuals due to PVL producing Staph aureus.<\/td><\/tr><tr><td>Scalded skin syndrome<br>(Lyell\u2019s syndrome in older children; Ritter\u2019s syndrome in infants)<\/td><td>S. aureus phage types group II and 71<\/td><td><\/td><\/tr><tr><td>Mycobacterium<\/td><td>\u2013 M. chelonae (tattoo-related infection),<br>\u2013 M. fortuitum,<br>\u2013 Mycobacterium marinum (fish tank or swimming pool granuloma),<br>\u2013 Mycobacterium ulcerans (ulcers like Bairnsdale ulcer or Buruli ulcer),<\/td><td><\/td><\/tr><tr><td>Sporotrichosis<\/td><td>Sporothrix schenkii<\/td><td>Cutaneous sporotrichosis is<br>acquired by contamination with soil, sphagnum moss or other vegetable matter and develops at the site of inoculation to form a primary lesion with lymphatic spread<\/td><\/tr><tr><td>Other<\/td><td>-cutaneous salmonellosis (vets, exposure to farm animals),<br>-Cutaneous listeriosis (HIV patients),<br>-Yersinia enterocolitica<\/td><td><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"reference\">Reference<\/h2>\n\n\n\n<p><a href=\"https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/766634\/B_11i6.5.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Public Health England. (2018). Investigation of swabs from skin and superficial soft tissue infections. UK Standards for Microbiology Investigations. B 11 Issue 6.5.<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Specimen Advice for the users: Safety Processing Gram stain \u2013 usually not done unless deep-seated pus from a normally sterile [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ngg_post_thumbnail":0,"footnotes":""},"categories":[60],"tags":[64,63,65],"class_list":["post-289","post","type-post","status-publish","format-standard","hentry","category-laboratory","tag-laboratory","tag-smi","tag-soft-tissue-infection"],"_links":{"self":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts\/289","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=289"}],"version-history":[{"count":2,"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts\/289\/revisions"}],"predecessor-version":[{"id":291,"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts\/289\/revisions\/291"}],"wp:attachment":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=289"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=289"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=289"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}