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A 1.5 Hour Procedure for Identification of Enterococcus Species Directly from Blood Cultures

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Factors Associated With Laboratory Test Negativity Following a Transition in Specimen Collection in Microbial

Keith D Miller¹, Avi Toiv¹, Callie Deng¹

¹Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, MI, USA.

Current Eye Research

|January 5, 2024

Summary

Negative laboratory results in microbial keratitis are increasing, with over 60% of tests negative by 2022. Antibiotic pretreatment and new collection methods like ESwab are linked to these negative results.

Keywords:

ESwab corneal ulcer culture microbial keratitis

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Area of Science:

Ophthalmology
Infectious Diseases
Clinical Microbiology

Background:

Microbial keratitis treatment is challenged by negative laboratory results.
Understanding factors influencing laboratory negativity is crucial for effective patient management.
A transition to a new specimen collection method occurred during the study period.

Purpose of the Study:

To investigate factors associated with laboratory negativity in microbial keratitis patients.
To evaluate the impact of a new specimen collection method on laboratory results.
To identify demographic and clinical factors related to negative laboratory findings.

Main Methods:

Retrospective analysis of 3395 microbial keratitis patients from August 2012 to April 2022.
Evaluation of laboratory test utilization and negativity rates over time.
Multivariable logistic regression to assess associations between negative results and patient factors, including pretreatment and specimen collection method (ESwab).

Main Results:

Laboratory testing increased significantly over time (2.5% per year), as did the negative result rate (2.2% per year).
Corticosteroid pretreatment was associated with lower odds of negative results (OR=0.49).
Increased antibiotic pretreatment (OR=1.30) and use of ESwabs (OR=1.69) were associated with higher odds of negative laboratory results.

Conclusions:

Microbial keratitis laboratory testing and negative result rates are increasing.
Antibiotic pretreatment and the use of ESwabs are associated with negative laboratory findings.
Further research is needed to optimize diagnostic strategies for microbial keratitis.