1. New test for the diagnosis of bacterial endophthalmitis
- Author
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Cécile Allouch, Elena Basli, Sandrine Degorge, L. Batellier, Sandrine Boutboul, Pablo Goldschmidt, Christine Chaumeil, Vincent Borderie, Djida Benallaoua, Laurent Laroche, and Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts (CHNO)
- Subjects
DNA, Bacterial ,Polymerase Chain Reaction ,Sensitivity and Specificity ,Microbiology ,Melting curve analysis ,Vitreous ,Retina ,law.invention ,Aqueous Humor ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Endophthalmitis ,law ,Haemophilus ,medicine ,Humans ,Polymerase chain reaction ,0303 health sciences ,biology ,030306 microbiology ,Aqueous humour ,Pseudomonas ,Acinetobacter ,biology.organism_classification ,medicine.disease ,Sensory Systems ,3. Good health ,Bacterial Typing Techniques ,Vitreous Body ,Ophthalmology ,030221 ophthalmology & optometry ,Diagnostic tests/Investigation ,Bacteria ,Bacterial Endophthalmitis - Abstract
Diagnosis of bacterial endophthalmitis (BE) often fails due to: (1) insufficient volumes of vitreous fluid (VF) and aqueous humour (AH); (2) lack of sensitivity of culture; (3) antibiotic treatments; (4) polymerase chain reaction (PCR) cross-contamination; and (5) limitations on the interpretation of the real-time PCR melting curve. We developed a fast real-time (f-real-t) PCR to improve the performance of the laboratory diagnosis of BE.The following samples were processed after adding an internal control: phosphate buffered saline (PBS); VF, AH and cell suspensions spiked with Bacteria (Bac); VF and AH from patients with endophthalmitis; and VF and AH from non-infective patients. DNA was extracted (MagNA Pure) and added to four tubes containing selected primers and probes for the identification and quantification of all Bac and eight genera by f-real-t PCR. Diagnostic performances based on direct microscopic examination, culture and f-real-t PCR were compared.The f-real-t PCR detected at least 0.01 colony-forming units (CFU) of Bac/microl with no cross-reactivity with fungi. Correlation with culture-positive results was 100%. Sixty per cent of BE samples tested culture-positive, but f-real-t PCR tested positive for 90%. Samples from non-infective cases were negative.The f-real-t PCR detected and quantified Bac, Staphylococci, Streptococci, Haemophilus, Pseudomonas, Enterobacteria, Acinetobacter, Propionibacteriacae and Corynebacteria in one run. Cultures required several hours to days (with a non-negligible number of false-negative results) and the f-real-t PCR was completed in 90 min. The f-real-t PCR is presented as a new tool for the diagnosis of BE: its usefulness requires validation with larger series of samples.
- Published
- 2009
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