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S.P. Mollan, A. Gao, A. Lockwood, L. Butler, O.M. Durrani; Microbial Isolates and the Sensitivity and Specificity of Anterior Chamber Tap (AC Tap) and Vitreous Biopsies for Patients With Post–Operative Bacterial Endophthalmitis: A Study of 116 Confirmed Cases . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1410.
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Purpose: To analyze the common positive microbial isolates and the sensitivities and specificities of AC taps and vitreous biopsies in patients clinically diagnosed as having infective postoperative endophthalmitis. Methods: A retrospective, non–comparative case note review was carried out to identify all cases of post–operative endophthalmitis in our region over a 9–year period (January 1995 to November 2004). In addition to the demographic data, information about the type of diagnostic procedure (AC tap, vitreous biopsy or both) and the infecting organism from the culture positive samples was collected. Sensitivity, specificity & predictive values were calculated using standard statistical methods. Results: Of 116 cases of post–operative endophthalmitis identified. 44 were female and 72 were male with a mean age of 70.3 years (range 24–94yrs). Cultures were positive in 56.0% (n=65) of the patients. Coagulase negative staphylococcus was the most common organism identified (61.5%, n=40/65) followed by Streptococcal species (20%, n=13/65) and pseudomonas aeruginosa (4.6%, n=3/65). An AC tap yielded positive cultures in 22.5%(n=25/111) while vitreous biopsy was positive in 50.9% (n=58/114). The sensitivity of AC tap in the cohort was 0.24 while it was 0.5 for the vitreous biopsy: the specificity 100% for both. Conclusions: Coagulase negative staphyloccal species is the most common cause of endophthalmitis in our region followed by streptococcal species & pseudomonas aeruginosa. As neither AC tap nor vitreous biopsy have a very high sensitivity, a combination of the two is likely to have a higher diagnostic yield.
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