ArticleJournal of ophthalmic inflammation and infection2026
Contribution of 16S rRNA gene PCR to microbiological diagnosis of endophthalmitis: a retrospective clinical cohort study of 71 vitreous and aqueous humor samples.
Article in Journal of ophthalmic inflammation and infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCulture remains the reference method for microbiological diagnosis of endophthalmitis, but its sensitivity is limited by small sample volumes, prior antibiotics, and fastidious organisms. This study evaluates the diagnostic contribution of 16S rRNA gene-targeted polymerase chain reaction (PCR) in improving bacterial identification in patients with endophthalmitis, compared to conventional culture.
methodsWe conducted a retrospective cohort study including patients diagnosed with endophthalmitis and managed at Limoges University Hospital (France) from January 2018 to December 2024. Aqueous and/or vitreous samples were analyzed using both conventional culture and broad-range PCR targeting the bacterial 16S rRNA gene. The primary outcome was the global identification rate of pathogens by each method and their combination. Subgroup analyses considered the type of ocular sample.
resultsSeventy-one intraocular samples from 50 episodes were analyzed (41 aqueous humor, 30 vitreous). Culture allowed bacterial identification in 21.1% of cases (15/71), compared to 39.4% for PCR (28/71, p = 0.002). The approach combining culture and PCR reached 42.3% (30/71, p < 0.001). Notably, PCR was positive in 26.8% of culture-negative cases (15/56), providing additional identification. Vitreous samples yielded higher identification rates than aqueous samples for both cultures (36,7% vs. 9,8%) and PCR (56,7% vs. 26,8%).
conclusionsPCR targeting the 16S rRNA gene significantly increases the diagnostic and the microbiological yield of intraocular sampling in endophthalmitis, particularly in culture-negative cases and in vitreous specimens. These findings support the complementary role of PCR in the microbiological workup of endophthalmitis.
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