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[Diagnostic and therapeutic contribution of microbiological analysis in severe microbial keratitis at Reims University Hospital between 2012 and 2014].
J Fr Ophtalmol 2017; 40(1):8-16JF

Abstract

PURPOSE

To investigate the contribution of microbial analysis in the diagnosis and management of severe microbial keratitis.

MATERIAL AND METHOD

This is a monocentric retrospective study at the University Hospital of Reims from January 2012 to December 2014. Corneal scrapings with infectious keratitis were subjected to routine bacterial and fungal culture. PCR was also performed to detect various viral DNA (VZV, CMV, EBV, HSV 1 & 2, adenovirus) and Acanthamoeba sp. DNA. All contact lens cases were analyzed if available.

RESULTS

One hundred and six patients were hospitalized, including 30 contact lens wearers (28.3%). Sixty-four bacterial cultures were positive (68%). Twenty-five different bacterial species were identified with a majority of gram-positive bacteria (67.92%). Among contact lens wearers, the initial VA was better than non-wearers (P=0.0004) and 37% of bacteria identified (a plurality) were gram positive. Of 11 contact lens case analyzed, in only one case (3.3%) did the result correlate with the corneal culture. Only 9 samples from the 323 viral DNA extractions and real time PCR were positive (2.8%); 7 were HSV1. No prior antiviral therapy had been started. Fungal culture was positive in 2 of the 97 corneal samples taken and 63.6% of the contact lens cases (7/11 cases). Only one of the 40 Acanthamoeba sp. PCR's was positive.

CONCLUSION

The systematic performance of microbiological investigations is a good diagnostic approach given the polymorphism of clinical presentations of corneal ulcers, which can sometimes be extremely misleading. Culture of contact lens cases appears ineffective for the detection and determination of the causative microorganism. The high incidence of Staphylococcus in bacterial keratitis and the prevalence of infections with gram-positive bacteria in contact lens wearers were noted.

Authors+Show Affiliations

Service d'ophtalmologie, hôpital Robert-Debré, CHU de Reims, rue du Général-Koenig, 51090 Reims, France. Electronic address: jessycaliot@hotmail.fr.Service d'ophtalmologie, fondation ophtalmologique Adolphe-de-Rothschild, 29, rue Manin, 75019 Paris, France.Service d'ophtalmologie, hôpital Robert-Debré, CHU de Reims, rue du Général-Koenig, 51090 Reims, France.Laboratoire de virologie médicale et moléculaire, faculté de médecine, 51, avenue Cognac-Jay, 51092 Reims cedex, France.Service d'ophtalmologie, hôpital Robert-Debré, CHU de Reims, rue du Général-Koenig, 51090 Reims, France.

Pub Type(s)

Journal Article

Language

fre

PubMed ID

27989423

Citation

Caliot, J, et al. "[Diagnostic and Therapeutic Contribution of Microbiological Analysis in Severe Microbial Keratitis at Reims University Hospital Between 2012 and 2014]." Journal Francais D'ophtalmologie, vol. 40, no. 1, 2017, pp. 8-16.
Caliot J, Guindolet D, Ducasse A, et al. [Diagnostic and therapeutic contribution of microbiological analysis in severe microbial keratitis at Reims University Hospital between 2012 and 2014]. J Fr Ophtalmol. 2017;40(1):8-16.
Caliot, J., Guindolet, D., Ducasse, A., Andreoletti, L., & Arndt, C. (2017). [Diagnostic and therapeutic contribution of microbiological analysis in severe microbial keratitis at Reims University Hospital between 2012 and 2014]. Journal Francais D'ophtalmologie, 40(1), pp. 8-16. doi:10.1016/j.jfo.2016.09.010.
Caliot J, et al. [Diagnostic and Therapeutic Contribution of Microbiological Analysis in Severe Microbial Keratitis at Reims University Hospital Between 2012 and 2014]. J Fr Ophtalmol. 2017;40(1):8-16. PubMed PMID: 27989423.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Diagnostic and therapeutic contribution of microbiological analysis in severe microbial keratitis at Reims University Hospital between 2012 and 2014]. AU - Caliot,J, AU - Guindolet,D, AU - Ducasse,A, AU - Andreoletti,L, AU - Arndt,C, Y1 - 2016/12/15/ PY - 2016/02/28/received PY - 2016/08/02/revised PY - 2016/09/16/accepted PY - 2016/12/19/pubmed PY - 2017/9/8/medline PY - 2016/12/20/entrez KW - Abcès KW - Analyses microbiennes KW - Bacterial cultures KW - Contact lens wear KW - Corneal abscess KW - Corneal scraping KW - Cultures bactériennes KW - Fungal keratitis KW - Grattage cornéen KW - Kératite fongique KW - Kératite infectieuse grave KW - Microbial analysis KW - PCR virales KW - Porteur de lentille de contact KW - Severe microbial keratitis KW - Viral PCR SP - 8 EP - 16 JF - Journal francais d'ophtalmologie JO - J Fr Ophtalmol VL - 40 IS - 1 N2 - PURPOSE: To investigate the contribution of microbial analysis in the diagnosis and management of severe microbial keratitis. MATERIAL AND METHOD: This is a monocentric retrospective study at the University Hospital of Reims from January 2012 to December 2014. Corneal scrapings with infectious keratitis were subjected to routine bacterial and fungal culture. PCR was also performed to detect various viral DNA (VZV, CMV, EBV, HSV 1 & 2, adenovirus) and Acanthamoeba sp. DNA. All contact lens cases were analyzed if available. RESULTS: One hundred and six patients were hospitalized, including 30 contact lens wearers (28.3%). Sixty-four bacterial cultures were positive (68%). Twenty-five different bacterial species were identified with a majority of gram-positive bacteria (67.92%). Among contact lens wearers, the initial VA was better than non-wearers (P=0.0004) and 37% of bacteria identified (a plurality) were gram positive. Of 11 contact lens case analyzed, in only one case (3.3%) did the result correlate with the corneal culture. Only 9 samples from the 323 viral DNA extractions and real time PCR were positive (2.8%); 7 were HSV1. No prior antiviral therapy had been started. Fungal culture was positive in 2 of the 97 corneal samples taken and 63.6% of the contact lens cases (7/11 cases). Only one of the 40 Acanthamoeba sp. PCR's was positive. CONCLUSION: The systematic performance of microbiological investigations is a good diagnostic approach given the polymorphism of clinical presentations of corneal ulcers, which can sometimes be extremely misleading. Culture of contact lens cases appears ineffective for the detection and determination of the causative microorganism. The high incidence of Staphylococcus in bacterial keratitis and the prevalence of infections with gram-positive bacteria in contact lens wearers were noted. SN - 1773-0597 UR - https://www.unboundmedicine.com/medline/citation/27989423/[Diagnostic_and_therapeutic_contribution_of_microbiological_analysis_in_severe_microbial_keratitis_at_Reims_University_Hospital_between_2012_and_2014]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0181-5512(16)30256-X DB - PRIME DP - Unbound Medicine ER -