Abstract
OBJECTIVE:To report our experience using conventional culture methods (CM) and pediatric blood culture bottles (PBCBs) for vitreous sample culture of acute postoperative endophthalmitis.METHODS:A retrospective study was conducted at the Department of Ophthalmology, Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, BR, from January 2010 to December 2015, and it included 54 patients with clinically suspected acute postoperative endophthalmitis. Vitreous samples were obtained by vitreous tap or vitrectomy. Samples from January 2010 to December 2011 were cultivated in CM, whereas samples from January 2012 to December 2015 were inoculated in PBCBs. The measured outcome was the yield of positive cultures.RESULTS:Twenty cases were included in the CM group, and 34 cases were included in the PBCB group. The yield of positive cultures in PBCBs (64.7%) was significantly higher than that in conventional CM (35%, p=0.034). Staphylococcus epidermidis and Streptococcus viridans were the two most commonly found agents.CONCLUSION:PBCBs can be used successfully in clinically suspected endophthalmitis. The method showed a higher yield of positive cultures than the conventional method. This technique appears to have several advantages over the traditional method: it saves time, as only one medium needs to be inoculated; transportation to a laboratory is easier than in the traditional method, and there is no need to maintain a supply of fresh agar media. The use of PBCBs may be recommended as the primary method for microbiological diagnosis and is especially suitable for office settings and remote clinics.
Highlights
Endophthalmitis is a serious intraocular infectious disease associated with elective surgical procedures (75 to 80%), ocular trauma (3.3 to 17%) and endogenous infections (5-15%) [1,2,3]
The present study aimed to report our own experience using pediatric blood culture bottles (BCBs) (PBCBs) and conventional media for vitreous sample culture in acute postoperative endophthalmitis
Positive samples from culture methods (CM) or PBCBs were later inoculated in sheep blood and chocolate agar and incubated for 48 hours under a 5% CO2 atmosphere
Summary
Endophthalmitis is a serious intraocular infectious disease associated with elective surgical procedures (75 to 80%), ocular trauma (3.3 to 17%) and endogenous infections (5-15%) [1,2,3]. Suspected cases are initially treated with intravitreal injection of broad-spectrum antibiotics (vancomycin and ceftazidime) [4]. The use of sample cultures is essential to confirming endophthalmitis etiology. Several conditions such as ocular inflammation from noninfectious uveitis, fungal endophthalmitis, and toxic anterior segment syndrome may mimic clinical. Received for publication on May 27, 2018. Accepted for publication on December 7, 2018. Identification of the pathogen in cases of endophthalmitis may improve treatment by the early introduction of targeted antibiotics
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