May 2005
Volume 46, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2005
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
Author Affiliations & Notes
  • S.P. Mollan
    Birmingham & Midland Eye Centre, Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
  • A. Gao
    Academic Unit of Ophthalmology, The University of Birmingham, UK, Birmingham, United Kingdom
  • A. Lockwood
    Birmingham & Midland Eye Centre, Sandwell & West Birmingham Hospitals NHS trust, Birmingham, United Kingdom
  • L. Butler
    Birmingham & Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS trust, Birmingham, United Kingdom
  • O.M. Durrani
    Academic Unit of Ophthalmology, The University of Birmingham, UK, Birmingham, United Kingdom
    Birmingham & Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS trust, Birmingham, United Kingdom
  • Footnotes
    Commercial Relationships  S.P. Mollan, None; A. Gao, None; A. Lockwood, None; L. Butler, None; O.M. Durrani, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2005, Vol.46, 1410. doi:
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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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Abstract

Abstract: : 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.

Keywords: endophthalmitis • anterior chamber • vitreous 
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