Comparison of Vitreous Culture Results in Patients with Suspected Endophthalmitis Using Pediatric Blood Culture Bottles and Conventional Culture Method at Mettapracharak (Wat Rai Khing) Hospital

Abstract

         Endophthalmitis is an ophthalmic emergency that may cause permanent vision loss. Rapid and accurate diagnosis through vitreous culture is crucial for appropriate treatment, but conventional culture methods require large specimen volumes while obtainable vitreous fluid is often limited. This study aimed to compare the detection rates and evaluate the agreement between usage of pediatric blood culture bottle (PBCB) and conventional culture method (CCM) in 60 patients with clinically suspected endophthalmitis. Each sample was cultured using both methods simultaneously, with Gram stain and KOH preparation performed. Detection rates for PBCB and CCM were 15.00% and 13.33%, respectively. Both methods demonstrated substantial agreement (Cohen's Kappa = 0.795) with 95.00% concordance. Gram stain was positive in only 5.00% of cases and showed significant correlation with CCM results (p = 0.002). This study demonstrates that both methods provide comparable detection rates with high agreement. Combined use may increase overall detection rates, benefiting timely diagnosis and treatment. Although Gram stain has low sensitivity, positive results correlate with culture outcomes and should always be performed alongside culture methods to provide preliminary information for appropriate antibiotic selection.