Targeted PCR and Acute Endophthalmitis

Study Overview
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Brief Summary
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Endophthalmitis is a serious eye infection of exogenous origin (post-operational, post-traumatic) or endogenous origin (metastatic). This is a diagnostic and therapeutic emergency. Each patient suffering from endophthalmitis must have immediately an ocular sampling, an intra ocular injection of antibiotics and a systemic antibiotic cover. The etiological treatment will be adapted according to the infectious agent.

Detailed Description
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The main goal of this prospective multi-centre trial is to improve the sensitivity and rapidity of the infectious agent's identification involved in endophthalmitis cases, particularly virulent species (like Staphylococcus aureus, Streptococcus pneumoniae...) from ocular samples with the help of real-time PCR. This will help the ophthalmologist to be more efficient in accordance with the kind of the bacteria. Data will also enable to compare both PCR techniques used in this study. The secondary goal of the prospective study is to characterize the resistance of bacterial's species found during acute endophthalmitis with the antibiogram and by the study of resistance genes, to enable to correlate the resistance in vitro with the therapeutic response in vivo and get precious epidemiological data to adapt prophylactic antibiotic.

Official Title
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Contribution of Fast Molecular Bacterial Identification by Real-time PCR in Managing of Postoperative Acute Endophthalmitis

Conditions
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Acute Endophthalmitis Post-operative

Intervention / Treatment
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* Biological: PCR : 16S ribosomal DNA and real-time targeted PCR
* Biological: Sampling of aqueous humour


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects affiliated to the social security system Signed informed consent documentation Patients over 18 years Male or female person Patients hospitalized for diagnostic and therapeutic evaluation of a post-operative acute endophthalmitis, or within the context of a scheduled surgery with sampling of aqueous humour. Has given his or her consent, having been provided with detailed informations regarding to intraocular sampling. Exclusion Criteria: antibiotherapy via intravenous (< 8 days) for patients NON suffering from endophthalmitis (control group) Patient's participation to the study refused Patients under 18 years Patients adults under guardianship or curatorship, or unable to express his/her consent. Pregnant women Breastfeeding women Person deprived of liberty

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Endophthalmitis sufferers<br>Patients hospitalized for diagnostic and therapeutic evaluation of a post-operative acute endophthalmitis. | Biological: PCR : 16S ribosomal DNA and real-time targeted PCR<br> <br> Biological: Sampling of aqueous humour<br> <br> |
| Other: Healthy control patient<br>Patients hospitalized in the context of a scheduled surgery with sampling of aqueous humour. | Biological: PCR : 16S ribosomal DNA and real-time targeted PCR<br> <br> Biological: Sampling of aqueous humour<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual acuteness | Clinical follow-up of patients | 2 minutes | 
| Intraocular pressure | Clinical follow-up of patients | 5 minutes | 
| Biomicroscopic exam with the slit lamp | State of anterior and posterior segment (back of the eye) | 3 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Acute Endophthalmitis., PCR, Ocular sampling