May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
16S rDNA PCR analysis of corneal infiltrates
Author Affiliations & Notes
  • T. Rudolph
    Ophthalmology, Sahlgrenska Univ Hosp Gothenburg, Molndal, Sweden
  • C. Welinder–Olsson
    Clinical Bacteriology, Sahlgrenska Univ Hosp Gothenburg, Gothenburg, Sweden
  • L. Lind–Brandberg
    Clinical Bacteriology, Sahlgrenska Univ Hosp Gothenburg, Gothenburg, Sweden
  • M. Egardt
    Ophthalmology, Sahlgrenska Univ Hosp Gothenburg, Molndal, Sweden
  • M. Neumann
    Ophthalmology, Sahlgrenska Univ Hosp Gothenburg, Molndal, Sweden
  • U. Stenevi
    Ophthalmology, Sahlgrenska Univ Hosp Gothenburg, Molndal, Sweden
  • Footnotes
    Commercial Relationships  T. Rudolph, None; C. Welinder–Olsson, None; L. Lind–Brandberg, None; M. Egardt, None; M. Neumann, None; U. Stenevi, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 108. doi:
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    • Get Citation

      T. Rudolph, C. Welinder–Olsson, L. Lind–Brandberg, M. Egardt, M. Neumann, U. Stenevi; 16S rDNA PCR analysis of corneal infiltrates . Invest. Ophthalmol. Vis. Sci. 2004;45(13):108.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: To evaluate polymerase chain reaction (PCR) of 16S ribosomal deoxyribonucleic acid (16S rDNA) as a diagnostic tool for patients with corneal infiltrates suspicious of bacterial keratitis. PCR had shown promising results in a previous case series of serious infectious keratitis (Rudolph et. al., submitted). Methods: Fifty consecutive patients who presented to our outpatient clinic with the diagnosis of corneal infiltrates compatible with bacterial keratitis were enrolled in this study. Patients with a typical marginal ulcer were excluded, based on individual judgement of the examiner. All patients showed epithelial staining/ulceration. The corneal infiltrates were characterized by diameter, localization and depth. Corneal scrapings of the patients were analyzed both by culture and PCR of 16S rDNA, followed by direct sequencing of the resulting amplicon. Results: The history of the patients included contact lens wear (50%), PKP (8%) and other conditions predisposing for keratitis. The infiltrates were smaller than 1mm in diameter in 19 (76%) cases of the contact lens group and in 8 (32%) for the rest. PCR and culture results were negative in 16 (84%) and 7 (88%) respectively. For the group with infiltrate size >1mm, 10 (43%) patients had positive cultures. Culture and PCR were concordant in only 3 cases, identifying Staph. aureus twice and a Moraxella sp. PCR identified a Moraxella sp. and Pseudomonas aeruginosa in two culture negative cases who had been pretreated with local antibiotics. The clinical outcome was favourable in all cases, although some patients had other corneal or ocular pathology compromising visual acuity. Conclusions: At present, the sensitivity of PCR in the setting of mild to moderate keratitis does not seem to be superior to conventional cultures. However, it can be helpful in cases pretreated with local antibiotics.

Keywords: keratitis • bacterial disease • cornea: clinical science 
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