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[Microbiological diagnosis of ocular infections]
Lorena López-Cerero1, Jaime Etxebarria, José Mensa
1Servicio de Microbiología, Hospital Virgen Macarena, Sevilla, España. llopez@us.es
Abstract:
The recent increase in the practice of ocular surgery and widespread use of contact lenses have led to an increase in the incidence of severe ocular infections. Inadequate management of these infections can result in irreversible loss of vision. Microbiological diagnosis is essential when the lesions are non-specific, recurrent, or unresponsive to antibiotic therapy, but is hampered by the difficulty of analyzing limited sample volumes containing small inocula. This document presents a review of the most important ocular infections according to the structure affected, and describes the most common causes of these infections and the situations in which a microbiological diagnosis is recommended. Information is included on the sample type and sampling methods, sample transport to the laboratory, and laboratory management and processing techniques, with special attention to liquid culture media. The yield of smear examination and culture of each type of ocular specimen is specified. Lastly, the molecular methods recently developed for the diagnosis of ocular fungal infections and Acanthamoeba infections are described.
Insights
Severe ocular infections are rising due to increased eye surgeries and contact lens use. Prompt microbiological diagnosis is crucial for effective management and preventing vision loss.
Area of Science:
- Ophthalmology
- Medical Microbiology
Context:
- Rising incidence of severe ocular infections linked to ocular surgery and contact lens use.
- Inadequate management can lead to irreversible vision loss.
- Challenges in microbiological diagnosis due to limited sample volumes and small inocula.
Purpose:
- To review significant ocular infections based on affected structures.
- To describe common causative agents and indications for microbiological diagnosis.
- To detail sample collection, transport, and laboratory processing, emphasizing liquid culture media.
Summary:
- Discusses common ocular infections, their causes, and when to seek microbiological diagnosis.
- Provides guidance on specimen types, sampling techniques, and laboratory procedures.
- Highlights the diagnostic yield of smear examination and culture, including novel molecular methods for fungal and Acanthamoeba infections.
Impact:
- Aids clinicians in diagnosing and managing severe ocular infections effectively.
- Improves laboratory diagnostic strategies for challenging ocular specimens.
- Facilitates timely and accurate identification of pathogens, potentially preventing vision loss.
