Complex Ocular Infection, Optimization of Microbiological Diagnosis
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Endophthalmitis
- Sponsor
- Assistance Publique - Hôpitaux de Paris
- Enrollment
- 153
- Locations
- 1
- Primary Endpoint
- Positivity rates of COI samples according to the new protocol
- Status
- Recruiting
- Last Updated
- 7 months ago
Overview
Brief Summary
The purpose of this study is to evaluate the impact of different technique to optimize the microbiological diagnosis of the COI.
- Metagenomic for the endophtalmitis
- Multiplex polymerase chain reaction for corneal abscesses
Detailed Description
Microbiological diagnosis of complex ocular infection (COI) (i.e: endophtalmitis and corneal abscess) is a current challenge. Indeed, endophtalmitis are often germ-free because a lack of microbiological diagnosis due to small volume to analyze and a complex site to attain. The microbiological etiologies of corneal abscesses are more frequently identified. Since few years, new molecular tools are developed in infectious diseases to optimizing the microbiological diagnosis. The investigators implemented these techniques in our hospital to optimize the microbiological diagnosis of complex ocular infection (COI). Thus, endophtalmitis benefit, when the volume of the ocular sample is sufficient, of molecular techniques (16s PCR and metagenomic shotgun). Corneal abscesses could shortly benefit of multiplex PCR in order to reduce the time to diagnosis. The impact and accuracy of these techniques is unknown.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Adult patient
- •Patient presenting or having presented a clinical suspicion of complex ocular infection requiring a sample for microbiological diagnosis:
- •Corneal abscess requiring hospitalization
- •Any suspicion of endogenous or exogenous endophthalmitis.
- •Patient not opposed to participating in the research
Exclusion Criteria
- •Patient under guardianship or curatorship
- •Pregnant women
Outcomes
Primary Outcomes
Positivity rates of COI samples according to the new protocol
Time Frame: 2 weeks after taking samples
Before/after type comparison. Comparison of the positivity rates of COI samples according to the new protocol: (i) for endophthalmitis performing a vitreous puncture (PV) or an anterior chamber puncture (PCA), or corneal scraping, optimized with modification of microbiological techniques (culture on enriched medium alone associated with shotgun metagenomics), (ii) for severe corneal abscesses, addition to standard microbiological techniques of molecular biology tests (multiplex PCR and / or metagenomics). An COI will be considered with a positive microbiological diagnosis after multidisciplinary concertation considering the different results
Secondary Outcomes
- Modification or not of the anti-infectious treatment(At the end of the follow up: 18 months)
- Microbiological diagnosis of the infection(At the end of the follow up: 18 months)
- Time to microbiological diagnosis according to the different technic(At the end of the follow up: 18 months)
- Accuracy of the different technics according to the gold standard (microbiological culture)(At the end of the follow up: 18 months)
- Visual acuity(At the end of the follow up: 18 months)
- Cure rate(At the end of the follow up: 18 months)