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Culture & Sensitivity, Aerobic bacteria Eye Samples (Manual method)
Bacterial/ Viral
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No Fasting Required
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Identifies bacteria & antibiotic susceptibility.
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Culture & Sensitivity Aerobic bacteria Eye Samples (Manual method)
- Why is it done?
- Identifies and isolates aerobic bacterial pathogens from ocular samples (conjunctiva, cornea, eyelid, or tear film)
- Determines antibiotic susceptibility patterns to guide targeted antimicrobial therapy
- Diagnoses bacterial conjunctivitis, keratitis, blepharitis, endophthalmitis, and other ocular infections
- Performed when patients present with eye discharge, pain, redness, foreign body sensation, or vision changes suggestive of bacterial infection
- Indicated for severe infections, recurrent infections, or when empiric therapy has failed
- Used for post-operative infections following eye surgery or contact lens-related complications
- Normal Range
- No growth/Negative: Absence of aerobic bacterial colonies on culture media after 24-48 hours of incubation at 35-37°C
- Normal interpretation: No significant bacterial infection detected; symptoms may be viral, allergic, or non-infectious in nature
- Positive/Abnormal: Presence of bacterial colonies (≥1 CFU or colony forming unit depending on specimen type)
- Colony count reporting: Reported as 1+ to 4+ or as actual colony counts (1-10, 10-100, 100-1000, >1000 CFU/mL)
- Sensitivity reporting: Reported as Susceptible (S), Intermediate (I), or Resistant (R) using standardized breakpoints
- Interpretation
- Negative culture result: Indicates no aerobic bacterial infection; consider viral etiology (adenovirus, HSV), allergic conjunctivitis, or inadequate specimen collection
- Single species isolated: Likely represents the causative pathogen; use antibiotic susceptibility results for treatment selection
- Multiple species isolated: May indicate contamination from normal ocular flora; correlate with clinical presentation and predominant organism
- Susceptible (S) result: Organism is inhibited by standard doses of the antibiotic; appropriate for clinical use
- Intermediate (I) result: Organism may respond to higher doses or prolonged treatment; consider if ocular penetration allows adequate drug levels
- Resistant (R) result: Organism will not respond to standard doses; select alternative antibiotic based on susceptibility profile
- Common ocular pathogens: Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa (contact lens wearers), Moraxella catarrhalis
- Factors affecting results: Prior antibiotic use (may yield false negatives), contaminated specimen collection, improper specimen transport, inadequate sample volume, and use of topical anesthetics containing preservatives
- Associated Organs
- Primary organ system: Eye (ocular structures including conjunctiva, cornea, eyelid, tear film, and anterior chamber)
- Associated conditions - Conjunctivitis: Bacterial inflammation of conjunctiva presenting with discharge, erythema, and foreign body sensation
- Associated conditions - Keratitis: Corneal inflammation/infection with pain, photophobia, decreased vision, and potential corneal scarring or perforation if untreated
- Associated conditions - Blepharitis: Eyelid margin infection causing lid redness, swelling, crusting, and eyelash loss
- Associated conditions - Endophthalmitis: Serious intra-ocular infection with severe pain, vision loss, anterior chamber inflammation, and vitreous haze; medical emergency requiring urgent treatment
- Associated conditions - Post-operative infection: Infection following cataract surgery, corneal transplant, or other ocular procedures
- Associated conditions - Contact lens complications: Lens-induced keratitis, particularly with Pseudomonas aeruginosa in extended-wear contact lens users
- Potential complications of untreated infection: Corneal ulceration, scarring, perforation, vision loss, blindness, spread to deeper ocular structures, systemic sepsis, orbital cellulitis
- Follow-up Tests
- Gram stain: Performed simultaneously with culture for rapid morphologic identification of bacteria; helps guide initial empiric therapy
- Culture for anaerobic bacteria: May be ordered if anaerobic infection is suspected (less common in ocular samples)
- Fungal culture: Indicated if fungal keratitis is suspected, particularly in immunocompromised patients or those with history of fungal exposure
- Viral culture or PCR: Consider if herpes simplex virus, varicella-zoster virus, or adenovirus is suspected
- Confocal microscopy: For detailed corneal imaging in severe keratitis cases to assess depth and extent of infection
- Blood culture: May be warranted in endophthalmitis cases to detect systemic bacteremia
- Repeat culture: Recommended 48-72 hours after initiation of therapy to document treatment response in severe infections
- Clinical monitoring: Regular ophthalmologic evaluation daily to weekly depending on infection severity to assess treatment response
- Fasting Required?
- Fasting: No - Fasting is NOT required for this test
- Patient preparation: No special fasting or dietary restrictions are necessary
- Pre-test instructions: Avoid rubbing or touching the affected eye; do not instill any eye drops for at least 15-30 minutes prior to specimen collection if possible
- Medications to avoid: Discontinue topical antibiotics 24-48 hours prior to culture if not acutely symptomatic; continue therapy if acute infection. Avoid eye drops containing preservatives (benzalkonium chloride) immediately before collection as preservatives are bacteriostatic/bactericidal
- Specimen collection notes: Specimen should be collected using sterile swabs or by aspiration without topical anesthetics containing preservatives; transport to laboratory immediately without delay; use sterile, non-bacteriostatic swabs for collection
How our test process works!
