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

Diamond, J., Leeming, J., Coombs, G.ORCID: 0000-0003-1635-6506, 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.

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