Work

Repeat Intraocular Sampling and Microbiological Testing in Infectious Endophthalmitis: A 27‐Year Prospective Observational Study at an Australian Statewide Tertiary Referral Centre

Year: 2025

Type: article

Abstract: BACKGROUND: Endophthalmitis requiring multiple ocular tissue sampling for microbiological testing is uncommon and has not been previously studied. This study aims to analyse cases with at least two ocular tissue samplings and testing of different ocular samples against culture yields. METHODS: A 27-year prospective observational study using data from the Victorian Endophthalmitis Registry, managed through the REDCap data platform. The study included 314 patients (317 eyes) who underwent at least two aqueous or vitreous specimen collections. The primary outcome measures included microbiological culture results from repeat and multiple intraocular samples and identification of isolated microorganisms. RESULTS: The overall initial culture positivity rate was 75.7%, while the culture positivity rate at the second intervention was 34.7%. First vitreous taps had the highest culture yield (72.6%) among different sample types. Notably, 19.5% of eyes with initial negative vitreous cultures had subsequent positive results. Further analysis showed that 24.4% of eyes with initial negative vitreous cultures had corresponding positive aqueous cultures. Additionally, 12.2% of eyes with negative initial vitreous taps yielded positive cultures from vitreous biopsies or washings from vitrectomy. Staphylococcus and Streptococcus species were the main pathogens isolated (40.4% and 31.3% of cases respectively). CONCLUSIONS: Our study demonstrated the trends and utility of repeated and different ocular tissue sampling in challenging endophthalmitis. Aqueous taps are most useful at the first biopsy, beyond which it has little diagnostic value. A second sampling can be valuable in patients who are initially culture-negative. Surgical specimens contribute meaningfully to the overall culture yield and enhance cumulative culture positivity.

Source: Clinical and Experimental Ophthalmology

DOI: 10.1111/ceo.70003

Authors: Pravena Kumaran, Maedbh Rhatigan, Zelia Chiu, Jasmine Lichtenstein, Penelope J. Allen, Rosie C. H. Dawkins

Institutions: The Royal Victorian Eye & Ear Hospital, Centre for Eye Research Australia, University Hospital Galway, The University of Melbourne

Language: English

Topic: Ocular Infections and Treatments

Subfield: Ophthalmology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,150