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Factors Associated With Positive Microbial Culture in Patients With Endophthalmitis Based on Clinical Presentation
Riyaz Bhikoo1, Nancy Wang, Sarah Welch
1Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand.
Asia-Pacific Journal of Ophthalmology (Philadelphia, Pa.)
|January 29, 2020
Summary
Identifying factors for positive endophthalmitis cultures is crucial. Aqueous tap and vitrectomy significantly increase the chances of obtaining a positive culture in patients with endophthalmitis.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Endophthalmitis is a severe intraocular infection often leading to vision loss.
- Early and accurate diagnosis is critical for effective treatment and visual outcome.
- Microbial culture is essential for identifying causative pathogens and guiding antibiotic therapy.
Purpose of the Study:
- To determine factors associated with positive culture results in endophthalmitis patients.
- To evaluate the role of clinical presentation and multimodal intraocular sampling techniques.
- To enhance diagnostic yield in endophthalmitis cases.
Main Methods:
- Retrospective review of 259 endophthalmitis patients (2006-2018).
- Analysis of patient demographics, clinical findings, and intraocular fluid samples (aqueous and vitreous).
- Comparison of culture positivity rates between different sampling methods (aqueous tap, vitreous tap, vitrectomy).
Main Results:
- 52.1% of cases had positive cultures.
- Vitrectomy (OR 2.86) and absent red reflex (OR 2.73) were significantly associated with positive cultures.
- Aqueous tap (OR 2.06) also increased the likelihood of positive cultures.
Conclusions:
- A multimodal intraocular sampling strategy is recommended for endophthalmitis.
- Both aqueous tap and vitrectomy improve the probability of obtaining positive microbial cultures.
- These methods aid in pathogen identification and targeted treatment of endophthalmitis.
