Literature DB >> 32217118

Prognostic Utility of Whole-Genome Sequencing and Polymerase Chain Reaction Tests of Ocular Fluids in Postprocedural Endophthalmitis.

Cecilia S Lee1, Bryan Hong2, Sundeep K Kasi2, Christopher Aderman2, Katherine E Talcott2, Murtaza K Adam2, Bryan Yue3, Lakshmi Akileswaran4, Kenji Nakamichi4, Yue Wu4, Kasra A Rezaei4, Lisa C Olmos de Koo4, Yewlin E Chee4, Aaron Y Lee4, Sunir J Garg4, Russell N Van Gelder5.   

Abstract

PURPOSE: To associate detection of potential pathogen DNA in endophthalmitis with clinical outcomes.
DESIGN: Prospective cohort study.
METHODS: Patients in whom endophthalmitis was diagnosed following an intraocular procedure were recruited. Clinical outcome data from baseline, week-1, month-1, and month-3 visits were collected. Intraocular biopsy samples were cultured by standard methods. Quantitative polymerase chain reaction (qPCR) was performed for specific pathogens and whole-genome sequencing (WGS).
RESULTS: A total of 50 patients (mean age 72 years old; 52% male) were enrolled. Twenty-four cases were culture-positive and 26 were culture-negative. WGS identified the cultured organism in 76% of culture-positive cases and identified potential pathogens in 33% of culture-negative cases. Month-1 and -3 visual acuities did not vary by pathogen-positive versus pathogen-negative cases as detected by either culture or WGS. Visual outcomes of Staphylococcus epidermidis endophthalmitis were no different than those of pathogen-negative cases, whereas the patients infected with other pathogens showed worse outcome. Higher baseline bacterial DNA loads of bacteria other than those of S epidermidis detected by WGS were associated with worse month-1 and -3 visual acuity, whereas the S epidermidis loads did not appear to influence outcomes. Torque teno virus (TTV) and Merkel cell polyomavirus (MCV) were detected by qPCR in 49% and 19% of cases, respectively. Presence of TTV at presentation was associated with a higher rate of secondary pars plana vitrectomy (P = .009) and retinal detachment (P = .022).
CONCLUSIONS: The presence and higher load of bacteria other than S epidermidis detected by WGS or DNA from TTV by qPCR in ocular fluids is associated with worse outcomes in post-procedure endophthalmitis.
Copyright © 2020 Elsevier Inc. All rights reserved.

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Year:  2020        PMID: 32217118      PMCID: PMC7891843          DOI: 10.1016/j.ajo.2020.03.008

Source DB:  PubMed          Journal:  Am J Ophthalmol        ISSN: 0002-9394            Impact factor:   5.258


  38 in total

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