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Corneal biopsy with tissue micro homogenisation for isolation of organisms in bacterial keratitis

Diamond, J., Leeming, J., Coombs, G., Pearman, J., Sharma, A., Illingworth, C., Crawford, G. and Easty, D. (1999) Corneal biopsy with tissue micro homogenisation for isolation of organisms in bacterial keratitis. Eye, 13 (4). pp. 545-549.

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Purpose To evaluate a novel two-stage technique to increase yield of bacteria isolated from infected corneal ulcers.

Methods A new blade was designed to remove friable material from infected corneal ulcers. The new blade was used in combination with standard tissue micro-homogenisation equipment in a two-stage technique intended to distribute biopsy samples evenly between relevant agar plates. Patients with presumed-bacterial corneal ulcers underwent sequential corneal sampling using the new two-stage technique and a scalpel blade, used without micro-homogenisation (the order of sampling was varied between two groups). Bacterial isolation rates were compared using the chi-squared test.

Results Twenty-four patients with presumed-bacterial corneal ulcers were studied. The overall positive bacterial isolation rate was 88%, with identical bacterial isolation rates for the new two-stage technique and the scalpel blade (71%). The new technique isolated bacteria from three ulcers that had initially been ‘sterile’ when sampled with a scalpel blade. Polymicrobial infections were identified in two ulcers with the new blade where only a single organism had been identified using the scalpel blade (not significantly different).

Conclusions The new two-stage technique shows promise for improving bacterial isolation rates from presumed-bacterial corneal ulcers.

Publication Type: Journal Article
Publisher: Nature Publishing Group
Copyright: © 1999 Royal College of Ophthalmologists
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