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
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.
Study Type
OBSERVATIONAL
Enrollment
153
For endophtalmitis : optimizing culture and NGS will be realized For keratitis: Multiplex PCR will be added on ocular samples
Equipe mobile d'infectiologie, Cochin hospital
Paris, IDF, France
RECRUITINGPositivity rates of COI samples according to the new protocol
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
Time frame: 2 weeks after taking samples
Microbiological diagnosis of the infection
Analysis of a prospective cohort of COI
Time frame: At the end of the follow up: 18 months
Time to microbiological diagnosis according to the different technic
Analysis of a prospective cohort of COI
Time frame: At the end of the follow up: 18 months
Accuracy of the different technics according to the gold standard (microbiological culture)
Analysis of a prospective cohort of COI
Time frame: At the end of the follow up: 18 months
Visual acuity
Evaluation of visual acuity at the end of treatment and the cure rate. The investigators hypothesized that the improvement of the microbiological diagnosis allows an improvement of the therapeutic management and thus of the visual outcome.
Time frame: At the end of the follow up: 18 months
Cure rate
Evaluation of visual acuity at the end of treatment and the cure rate. The investigators hypothesized that the improvement of the microbiological diagnosis allows an improvement of the therapeutic management and thus of the visual outcome.
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Time frame: At the end of the follow up: 18 months
Modification or not of the anti-infectious treatment
Analysis of the impact of microbiological diagnosis on the choice of anti-infectious molecules.. The investigators hypothesized that the improvement of the microbiological diagnosis and the implementation of the COI management bundle will induce a modification of the prescription of anti-infectious molecules. The investigators will realize a qualitative and quantitative analysis of prescribed anti-infective molecules
Time frame: At the end of the follow up: 18 months