The use of pediatric blood culture bottles in the diagnosis of acute postoperative endophthalmitis

Abstract

 

Purpose

 

Sample culture is an essential laboratory procedure necessary to confirm the microbiological etiology and to prompt and appropriate treatment of endophthalmitis. Techniques for culturing vitreous samples vary. The traditional method for culturing the undiluted vitreous uses solid media plates and tioglicolate. Direct inoculation of blood culture bottles may be alternative.¹ Pediatric blood culture bottles may be suitable for samples of small amount.² The present study evaluated the culture yield in the diagnosis of endophthalmitis using for inoculation conventional methodology (CM) or pediatric blood culture bottle (PBCB).

 

Methods

 

This retrospective study included cases of clinically suspected acute postoperative endophthalmitis treated between January 2010 and December 2013 at Department of Ophthalmology, University of São Paulo, SP, Brazil. Undiluted vitreous were cultivated in CM from January 2010 to December 2011 and in PBCB from January 2012 to December 2013. The isolated agents and culture yield were analysed for each methodology. The study was approved by the Institutional Ethics Committee.

 

Results

 

Fourty two cases were included during this 4-year period. These cases were associated with phacoemulsification (n=20, 47.6%), trabeculectomy (n=9, 21.4%), extracapsular cataract extration (n=6, 14.3%), pars plana vitrectomy (n=4, 9.5%), phacoemulsification/trabeculectomy (n=2, 4,8%) and intravitreal bevacizumab injection (n=1, 2.4%). The most prevalent agents were Staphylococcus epidermidis (n=5, 23.8%), Streptococcus viridans (n=3, 14.3%), coagulase-negative Staphylococus (n=2, 9.5%) and Enterococcus faecalis (n=2, 9.5%). The culture yield of the 23 eyes cultured in CM was 36.4 % and of the 20 eyes cultured in PBCB was 65% (Table).

 

Conclusions

 

In spite of this non-comparative and retrospective study, pediatric blood culture bottle yielded substantially high positivity and seems a good alternative to CM if access to microbiological facilities is suboptimal. PBCB had some advantages over conventional methodology: easy inoculation, reduce the risk of contamination with transport and possibility of storage at room temperature.<br /> <br /> ¹ Joondeph BC et a. A new culture method for infectious endophthalmitis. Arch Ophthlamol 1989;107:1334-7; ² Heggers JP et al. The efficacy of pediatric bllod culture sets in the determinations of burn bacteremia. J Burn Care Rehabil 1990; 11:419-22  

 

Table