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Quantitative real-time PCR may offer rapid, accurate bacterial endophthalmitis diagnosis
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Quantitative real-time polymerase chain reaction accurately diagnosed cases of suspected bacterial endophthalmitis and may be a useful adjunct to traditional culture, according to a study.
“[Quantitative real-time polymerase chain reaction] is a valuable diagnostic tool for rapid diagnosis of bacterial endophthalmitis with higher sensitivity than routine bacterial culture. This technique provides quantitative information on bacterial pathogens in ocular fluids that can, in conjunction with Gram stain and culture, be useful in determining an initial therapeutic approach in patients presenting with suspected postoperative endophthalmitis,” the study authors said.
The prospective, single-center experimental study evaluated quantitative real-time polymerase chain reaction (qPCR) in the diagnosis of postoperative bacterial endophthalmitis in 64 patients who presented with clinical signs and symptoms of endophthalmitis within 1 year of undergoing cataract surgery at a tertiary care center.
The primary outcome measures were sensitivity of qPCR compared to culture and concordance of pathogen identification results with sequencing vs. phenotypic speciation. Exclusion criteria were glaucoma filtering or cornea surgery in the past year, postoperative trauma, fungal endophthalmitis and preoperative inflammatory conditions.
A control group consisted of 50 patients who underwent vitrectomy for noninflammatory indications.
Results showed that qPCR detected 16s bacterial DNA in 37 patients (66%), compared to 19 (34%) with traditional culture. One patient had a positive result by culture but negative result by qPCR.
There was a 100% concordance in pathogen identification for the 18 samples with positive results by qPCR and culture.
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Am J Ophthalmol. 2012;153(6):1031-1037.
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