diagnosis of bacterial endophthalmitis by nested- pcr in comparison with routine microbiological culture

purpose: to ascertain whether the use of nested-pcr (nested polymerase chain reaction) technique leads to more rapid and accurate diagnosis of bacterial endophthalmitis. methods: the aqueous humor and vitreous samples of 24 eyes of 24 patients with bacterial endophthalmitis were evaluated by microscopy, diagnostic aerobic culture, and nested- pcr to detect the infectious agent. results: aerobic cultures of the aqueous humor and the vitreous were positive in 1 eye (4%) and 6 eyes (25%), respectively. using nested-pcr, an infectious agent was detected in the aqueous humor of 14 eyes (58%) and in the vitreous of 17 eyes (70%). nested-pcr for eubacterial genome showed 100% correlation with bacteriologically positive specimens. eubacterial genome was detected in 11 of 18 bacteriologically negative cultures of the vitreous. conclusions: nested-pcr on aqueous humor and vitreous samples is a powerful and reliable tool for the diagnosis of bacterial endophthalmitis particularly in smear and culture negative specimens.