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S. Arnavielle, II, M. Passemard, C. Creuzot-Garcher, A. M. Bron, P. L. Cornut, G. Thuret, J. P. Romanet, Y. Benito, F. Vandenesch, C. Chiquet; Microbiological Culture and Universal PCR Yield in Acute Endophthalmitis Following Cataract Surgery After Intravitreous Antibiotics. Invest. Ophthalmol. Vis. Sci. 2007;48(13):349.
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The purpose of this study was to isolate bacteria in acute endophthalmitis after cataract surgery after intravitreal injection of antibiotics using cultures and eubacterial PCR.
We prospectively enrolled 100 eyes of 100 patients in a multicenter study (FRIENDS group, 2004-2005) who presented with acute endophthalmitis following cataract surgery. Fifty two patients underwent an aqueous humor (AH) sample before and after one antibiotic intravitreal injection (vancomycin and ceftazidime) while 17 patients underwent a vitreous tap before and after antibiotics intravitreal injections. Microbiological cultures were performed using BHI culture medium (Brain Heart Infusion) and eubacterial PCR on 16S ribosomal DNA followed by DNA sequencing.
In aqueous humor, microbiological cultures associated with PCR identified a bacteria in 48% of the cases before antibiotherapy and in 28.8% after intravitreal antibiotherapy. Positive cultures before treatment became negative after antibiotic treatment in 33% of the cases whereas initial positive PCR before became negative after antibiotic treatment in 29% of the cases. However PCR alllowed the identification of new bacteria after antibiotic injections in 8% of the patients.In vitreous samples, microbiological cultures and PCR identified a bacteria in 70.6% of cases before antibiotic treatment and in 82.3% after intravitreal injection. After antibiotic injection, initially positive cultures and PCR became negative in 80% and 8% of cases, respectively.
A single antibiotics intravitreous injection is not sufficient to eradicate the pathogens responsible for acute post operative endophthalmitis. Eubacterial PCR is useful for the microbiological identification in vitreous samples after intravitreal injection of antibiotics.
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