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Comparing Microbiologic Tests for Pathogen Detection in Infectious Keratitis Using Latent Class Analysis.

Michael Aaby¹, Prajna Lalitha², N Venkatesh Prajna³

¹Casey Eye Institute, Oregon Health & Science University, Portland, OR.

|December 11, 2025

Summary

This summary is machine-generated.

Next-generation sequencing (MDS) offers superior pathogen detection for infectious keratitis compared to traditional methods. MDS shows higher sensitivity and specificity, crucial for accurate diagnosis and preventing vision loss.

Keywords:

infectious keratitis latent class analysis metagenomic deep sequencing

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Area of Science:

Ophthalmology
Microbiology
Genomics

Background:

Infectious keratitis poses a significant threat to vision.
Accurate and rapid pathogen identification is critical for effective treatment.

Purpose of the Study:

To compare the diagnostic performance of traditional microbiologic tests with next-generation sequencing (MDS) for infectious keratitis.
Evaluate sensitivity and specificity of different diagnostic methods.

Main Methods:

Corneal scrapings from 86 infectious keratitis patients were analyzed.
Tests included Gram stain, KOH smear, culture, and metagenomic deep sequencing (MDS).
Latent class analysis was used to estimate test performance.

Main Results:

MDS demonstrated superior sensitivity and specificity for both bacterial and fungal keratitis compared to traditional methods.
Gram stain was effective for bacterial detection; KOH smears showed moderate fungal detection.
Culture had high specificity but low sensitivity, missing 29% of critical pathogens identified by MDS.

Conclusions:

Metagenomic deep sequencing (MDS) presents a promising diagnostic tool for infectious keratitis.
MDS offers a better balance of sensitivity and specificity than conventional methods.
Further validation in diverse settings is needed to optimize clinical utility.