Document Detail


Laboratory diagnosis of endophthalmitis: comparison of microbiology and molecular methods in the European Society of Cataract & Refractive Surgeons multicenter study and susceptibility testing.
MedLine Citation:
PMID:  18721702     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate and compare the use of molecular biology with the use of traditional Gram stain and organism culture for the laboratory diagnosis of postoperative endophthalmitis. SETTING: Twenty-four ophthalmology units together with 9 microbiology laboratories and 2 European reference molecular biology laboratories. METHODS: A prospective randomized partially masked multicenter cataract surgery study recruited 16 603 patients. This resulted in 29 cases of presumed postoperative endophthalmitis. Gram stain and culture were performed in the local laboratory according to agreed protocols. Samples of aqueous and/or vitreous were transported to the first referenced molecular biology laboratory (Regensburg, Germany) for polymerase chain reaction (PCR) testing, and an extracted aliquot of DNA was then referred to the second laboratory (Alicante, Spain) for PCR. RESULTS: Of the 29 who presented with presumed postoperative endophthalmitis, 20 were classified as proven infective endophthalmitis with positive Gram stain, culture, or PCR. Fourteen patients were culture-positive; all but 1 of these was also positive by PCR. Six patients were positive by PCR but negative by Gram stain or culture. Nine patients were negative by both microbiology and PCR testing. CONCLUSIONS: Use of molecular biology technique increased the laboratory rate of identifying the pathogen by 20%, confirming the technique is very useful for the endophthalmitis specimen. Samples of both aqueous and vitreous should be collected and stored at -20 degrees C for PCR at the time of the diagnostic taps.
Authors:
David Seal; Udo Reischl; Anke Behr; Consuelo Ferrer; Jorge Alió; Roland J Koerner; Peter Barry;
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of cataract and refractive surgery     Volume:  34     ISSN:  0886-3350     ISO Abbreviation:  J Cataract Refract Surg     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-25     Completed Date:  2008-10-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8604171     Medline TA:  J Cataract Refract Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1439-50     Citation Subset:  IM    
Affiliation:
Applied Vision Research Centre, City University, London, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Aqueous Humor / microbiology
Bacteria / genetics,  isolation & purification
Bacterial Typing Techniques / methods*
DNA, Bacterial / analysis
Endophthalmitis / diagnosis*,  microbiology
Europe
Eye Infections, Bacterial / diagnosis*,  microbiology
Gentian Violet
Humans
Microbial Sensitivity Tests
Ophthalmology / standards
Phacoemulsification
Phenazines
Polymerase Chain Reaction / methods*
Postoperative Complications / diagnosis*,  microbiology
Prospective Studies
Societies, Medical / standards
Vitreous Body / microbiology
Chemical
Reg. No./Substance:
0/DNA, Bacterial; 0/Gram's stain; 0/Phenazines; 548-62-9/Gentian Violet
Investigator
Investigator/Affiliation:
Peter Barry / ; David Seal / ; George Gettinby / ; Magnus Peterson / ; Crawford Revie / ; Fiona Lees / ; Klaus Geldsetzer / ; David Lloyd / ; Gunther Grabner / ; Stefan F Egger / ; Josef Ruckhofer / ; Johan Blanckaert / ; Jan Yperman Ziekenhuis / ; Camille Budo / ; Albert Galand / ; Jessica Crommen / ; Jean Rakic / ; Gaël Xhauflaire / ; Marie-José Tassignon / ; Hugo Verbraeken / ; Rita de Donker / ; Stefanie Schmickler / ; Roberto Bellucci / ; Simonetta Morselli / ; Sandro Soldati / ; Fausto Vigasio / ; Marco Bertelli / ; Andrea Bottoli / ; Marta Cassamali / ; Fabrizio Danieli / ; Samer Khuri / ; Luigina Rosa / ; Jerzy Szaflik / ; Jacek P Szaflik / ; Conceição Lobo / ; José Cunha-Vaz / ; Joaquin Mira / ; Augusto Abreu / ; José Aguilar / ; Victor Arteaga / ; Luis Cordovés / ; Valentín T Díaz-Alemán / ; Manuel Gonzalez de la Rosa / ; Cristina Mantolan / ; Pedro Abreu / ; Jorge Alvarez-Marín / ; María Antonia Gil / ; Jorge Alió / ; Miguel Teus / ; M T Alvarez / ; J M Román / ; Süleyman Kaynak / ; Osman Saatcy / ; Ysmet Durak / ; Uzeyir Günenç / ; Tülin Berk / ; Meltem Söylev / ; Hakan Oner / ; Nilüfer Koçak / ; Mehmet Ergin / ; David Allen / ; Peter Phelan / ; David Steel / ; Chris Wood / ; Carol Cunningham / ; Michael Miller / ; Ramesh Moorthy / ; Andeeb Zafar / ; Alex Ionides / ; Damian Lake / ; Graham Thompson / ; John Jacob / ; Daniel Bytes / ; Casper Gibbon / ; Andrew Kleinschmidt / ; Roland Ling / ; Anthony Quinn / ; Peter Simcock / ; George Sturrock / ; William Kiel / ; Denise Mabey / ; David Spalton / ; Anupma Kumar / ; Paul Rosen / ; C K Patel / ; John Salmon / ; Jean Dash / ; Linda Lindsell / ; Rebecca Turner / ; Susan Kennedy / ; Per Montan / ; Stephen Barrett / ; John Ludgate / ; Susanne Gardner / ; Kirk Wilhelmus /

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