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The Influence Of Needle Gauge And Infection Source On Vitreous Aspirate Cultures

Jesse M. Smith, Marc T. Mathias, Scott C. N. Oliver, N. Mandava, J. Olson, H. Quiroz-Mercado, A. Palestine
Published 2015 · Medicine, Biology

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Background/aims While the Endophthalmitis Vitrectomy Study (EVS) included only post-cataract surgery patients, the methods and data from that study are widely applied in the management of endophthalmitis of all types. We sought to examine how our experience with in-office vitreous aspiration differed from the EVS in two ways: first, by reviewing microbiological culture yields from vitreous aspirates obtained using 30-gauge needles versus 25–27-gauge needles and second, by reviewing culture yields in cases of endogenous versus non-endogenous endophthalmitis. Methods Cases of endophthalmitis over a 14-year period were reviewed when vitreous tap was the initial diagnostic procedure. The data included infection source, needle size used to obtain a vitreous aspirate, organism cultured and rates of unsuccessful attempts at vitreous aspiration or dry taps. Results 10 cases were endogenous endophthalmitis, while 36 cases were a mix of postoperative, post-traumatic, post-intravitreal injection and miscellaneous patients. A positive microbiological culture was obtained in 11/36 (31%) of vitreous taps using a 25–27-gauge needle and in 8/10 (80%) taps using a 30-gauge needle (p<0.01). A positive vitreous culture was obtained in 18/36 (50%) of all non-endogenous cases, while a positive result was obtained in 0/10 (0%) cases of endogenous endophthalmitis (p<0.01). Conclusions The use of a smaller needle in obtaining vitreous samples in endophthalmitis did not lower the microbiological yield. A positive microbiological yield was significantly less likely in cases of endogenous endophthalmitis compared with non-endogenous cases. Vitreous tap as a method for identifying the causative organism in endogenous endophthalmitis was of limited utility.
This paper references
Vitreous cultures in suspected endophthalmitis. Biopsy or vitrectomy?
S. Donahue (1993)
Endogenous bacterial endophthalmitis: a 17-year prospective series and review of 267 reported cases.
T. Jackson (2003)
Endogenous endophthalmitis: 10-year experience at a tertiary referral centre
P. Connell (2011)
Endogenous endophthalmitis.
A. Baker (1994)
Endogenous bacterial endophthalmitis. Report of a ten-year retrospective study.
A. Okada (1994)
Endogenous Endophthalmitis: An 18-Year Review of Culture-Positive Cases at a Tertiary Care Center
Monica I Binder (2003)
Endophthalmitis at the Bristol Eye Hospital: an 11-year review of 47 patients.
I. Hassan (1992)
Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Endophthalmitis Vitrectomy Study Group.
Endophthalmitis: Pathogenesis, clinical presentation, management, and perspectives
M. Kernt (2010)
Report of a ten-year retrospective study
A A Okada (1994)
Culture-proven endogenous endophthalmitis: clinical features and visual acuity outcomes.
Vivian Schiedler (2004)
Endogenous fungal endophthalmitis: risk factors, clinical features, and treatment outcomes in mold and yeast infections
Jayanth Sridhar (2013)
Importance of accurate sampling techniques in microbiological diagnosis of endophthalmitis.
A. Banu (2011)
Metastatic bacterial endophthalmitis: a contemporary reappraisal.
M. Greenwald (1986)
Syringe and Needle Size, Syringe Type, Vacuum Generation, and Needle Control in Aspiration Procedures
L. Haseler (2010)
Microbiologic yields and complication rates of vitreous needle aspiration versus mechanized vitreous biopsy in the endophthalmitis vitrectomy study.
E. Stroh (1999)
Endogenous fungal endophthalmitis: causative organisms, management strategies, and visual acuity outcomes.
K. Chen (2012)

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