Emerging techniques for pathogen discovery in endophthalmitis

• Published in: Current opinion in ophthalmology Vol. 26; no. 3; pp. 221 - 225
• Main Authors: Hong, Bryan K, Lee, Cecilia S, Van Gelder, Russell N, Garg, Sunir J
• Format: Journal Article
• Language: English
• Published: United States Copyright Wolters Kluwer Health, Inc. All rights reserved 01-05-2015
• Subjects: Bacteria - genetics; Bacteria - isolation & purification; DNA, Bacterial - genetics; Endophthalmitis - microbiology; Eye Infections - microbiology; High-Throughput Nucleotide Sequencing - methods; Humans; Karyotyping; Metagenome - genetics; Real-Time Polymerase Chain Reaction; Vitreous Body - microbiology
• ISSN: 1040-8738; 1531-7021
• DOI: 10.1097/ICU.0000000000000145

PURPOSE OF REVIEWDespite the inability to detect certain organisms and relatively low yield, microbial culture is the current gold standard for the diagnosis of most intraocular infections. Research on alternative molecular diagnostic methods has produced an array of strategies that augment and improve pathogen detection. This review summarizes the most recent literature on this topic.
RECENT FINDINGSThe yield of traditional microbial culture has not improved since the Endophthalmitis Vitrectomy Study results were published 20 years ago. Advances in PCR methods have enabled quantification of pathogen load and screening for multiple organisms at once. More recently, deep sequencing techniques allow highly sensitive detection of any DNA-based life form in a specimen. This offers the promise of not only improved detection of traditional organisms but can also identify organisms not previously associated with endophthalmitis.
SUMMARYMolecular diagnostic methods enhance the results of microbial culture and may become the new standard in the diagnosis of intraocular infections.