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Effectiveness of sampling methods employed for Acanthamoeba keratitis diagnosis by culture

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Abstract

Purpose

This retrospective, observational study was designed to evaluate the effectiveness of the sampling methods commonly used for the collection of corneal scrapes for the diagnosis of Acanthamoeba keratitis (AK) by culture, in terms of their ability to provide a positive result.

Methods

A total of 553 samples from 380 patients with suspected AK received at the Parasitology Section of the Public Health Institute of Chile, between January 2005 and December 2015, were evaluated. A logistic regression model was used to determine the correlation between the culture outcome (positive or negative) and the method for sample collection. The year of sample collection was also included in the analysis as a confounding variable.

Results

Three hundred and sixty-five samples (27%) from 122 patients (32.1%) were positive by culture. The distribution of sample types was as follows: 142 corneal scrapes collected using a modified bezel needle (a novel method developed by a team of Chilean corneologists), 176 corneal scrapes obtained using a scalpel, 50 corneal biopsies, 30 corneal swabs, and 155 non-biological materials including contact lens and its paraphernalia. Biopsy provided the highest likelihood ratio for a positive result by culture (1.89), followed by non-biological materials (1.10) and corneal scrapes obtained using a modified needle (1.00). The lowest likelihood ratio was estimated for corneal scrapes obtained using a scalpel (0.88) and cotton swabs (0.78).

Conclusion

Apart from biopsy, optimum corneal samples for the improved diagnosis of AK can be obtained using a modified bezel needle instead of a scalpel, while cotton swabs are not recommended.

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Acknowledgements

The authors would like to thank the personnel and authorities of the Laboratory of Parasitology at the Public Health Institute of Chile for their support and readiness to cooperate with medical professionals and researchers in the advancement of scientific knowledge.

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Authors and Affiliations

  1. Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile

    Laura Muiño

  2. Clínica Oftalmológica Pasteur, Santiago, Chile

    Donoso Rodrigo

  3. Facultad de Medicina, Universidad de Chile, Santiago, Chile

    Donoso Rodrigo

  4. Departamento de Asuntos Científicos, Instituto de Salud Pública de Chile, Santiago, Chile

    Rodrigo Villegas

  5. Departamento de Oftalmología, Hospital Clínico José Joaquín Aguirre, Universidad de Chile, Santiago, Chile

    Pablo Romero

  6. Unidad de Trauma Ocular, Hospital El Salvador, Universidad de Chile, Santiago, Chile

    Daniel E. Peredo

  7. Fundación Oftalmológica Los Andes, Santiago, Chile

    Rafael A. Vargas

  8. Sección Parasitología, Departamento Laboratorio Biomédico, Instituto de Salud Pública de Chile, Av. Marathon 1000, CP 7780050, Ñuñoa, Santiago, Chile

    Daniela Liempi & María Isabel Jercic

  9. Grupo de Bioquímica y Parasitología Molecular, Departamento de Parasitología, Instituto de Biotecnología, Universidad de Granada, Campus Universitario Fuentenueva, 18071, Granada, Spain

    Antonio Osuna & María Isabel Jercic

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  1. Laura Muiño
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  2. Donoso Rodrigo
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  3. Rodrigo Villegas
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  4. Pablo Romero
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  5. Daniel E. Peredo
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  6. Rafael A. Vargas
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  7. Daniela Liempi
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  8. Antonio Osuna
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  9. María Isabel Jercic
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Corresponding author

Correspondence to María Isabel Jercic.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony, or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

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Muiño, L., Rodrigo, D., Villegas, R. et al. Effectiveness of sampling methods employed for Acanthamoeba keratitis diagnosis by culture. Int Ophthalmol 39, 1451–1458 (2019). https://doi.org/10.1007/s10792-018-0958-3

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  • DOI: https://doi.org/10.1007/s10792-018-0958-3

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