Rapid Diagnostic Work-Up of Streptococcus dysgalactiae Endophthalmitis by a Novel Culture Processing System

  1. Erin Su
  2. Jessica Chang
  3. Khay Ugaban
  4. Rosemary She

Reviewed by

Read the full article See related articles

Discuss this preprint

Start a discussion What are Sciety discussions?

Listed in

This article is not in any list yet, why not save it to one of your lists.
Log in to save this article

Abstract

The diagnosis of infective endophthalmitis is supported by microbiologic work-up. Rapid work-up is critical to confirm clinical suspicion and enable appropriate antimicrobial therapy. We report the novel use of an automated liquid culture processing system (Fast System, Qvella Corporation) in a vitreous fluid culture. A 59-year-old patient with post-operative endophthalmitis presented with acute right eye pain and blurred vision. Vitreous fluid collected for microbiology culture was of limited quantity and only inoculated to thioglycolate broth. Broth culture recovered beta-hemolytic, group G Streptococcus dysgalactiae susceptible to penicillin and vancomycin. Experimental application of the Fast System to isolate and concentrate the organism from the broth culture yielded the same identification and susceptibility test results but one day sooner than the standard workflow. Despite prompt treatment with appropriate antibiotics including vancomycin and ceftriaxone, disease progressed rapidly and required enucleation to achieve a stable therapeutic outcome. Use of automated processors such as the FAST System for monomicrobial broth cultures has thus far focused on positive blood culture broths, but could potentially include other liquid-based cultures such as for sterile body fluids of critical nature.

Article activity feed

  1. Access Microbiology

    I am pleased to tell you that your article has now been accepted for publication in Access Microbiology. The work presented is clear and the arguments well formed. The manuscript is well written and contributes to the literature. Thank you for addressing all reviewers comments satisfactorily and in a timely manner.

  2. Version published to 10.1099/acmi.0.000645.v2 on Access Microbiology
  3. Version published to 10.1099/acmi.0.000645.v3 on Access Microbiology
  4. Access Microbiology

    Thank you for submitting your manuscript for publication in Access Microbiology. It has been examined by expert reviewers who have concluded that the work is of potential interest to the readership of Access Microbiology. However, based on the comments received, a minor revision of this manuscript will be required before a decision can be made on its publication. I will be pleased to consider a revised manuscript along with a document including a point by point response to each of the reviewers comments. Your revised manuscript may be returned to one or more of the original reviewers, along with your itemised response to the reviewers’ comments.

  5. Access Microbiology

    Comments to Author

    This manuscript reports a case report of a patient with streptococcal endophthalmitis who was diagnosed using the Qvella Fast system. This system uses a so-called "liquid colony" to enable rapid identification and antimicrobial susceptibility testing. The system was developed to be used on positive blood culture broths. The authors report the successful use on a vitreous sample in a thioglycolate broth from a patient with endophthalmitis. Even though not very surprisingly, the system worked well on this sample type. Hence, the report is a nice illustration of this possible off-label use of the Qvella Fast system for specimens other than blood cultures. Specific comments: 1) Abstract: It is reported that the patient was treated with vancomycin and ceftriaxone. However, no mention of ceftriaxone is made in the main text (but rather ceftazidime). Please clarify which antibiotic was used. 2) Discussion: When discussing published reports on the accuracy of the Qvella Fast system, some additional studies have been published in the meantime, which I would suggest to add, e.g. PubMed ID (PMID) 37768103 and 37296699. 3) Discussion: I believe it would be useful to mention also available, alternative techniques such as MALDI-TOF Sepsityper which can be used for direct pathogen identification in blood culture broths, and potentially, other broth types. 4) References: Please ensure that pathogen names are written in italics.

    Please rate the quality of the presentation and structure of the manuscript

    Very good

    To what extent are the conclusions supported by the data?

    Strongly support

    Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?

    No

    Is there a potential financial or other conflict of interest between yourself and the author(s)?

    No

    If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?

    Yes

  6. Access Microbiology

    Comments to Author

    1. Description of the case is very good written! 2. Presentation of results: I would like to analyze it a bit more 3. The paper should be revised by a native speaker, because it has some grammatical and punctuation errors. 4. The paper has a high similarity (19%) with non cited publications , please try to lower that percentage.

    Please rate the quality of the presentation and structure of the manuscript

    Good

    To what extent are the conclusions supported by the data?

    Strongly support

    Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?

    Yes: The article has a high similarity percentage. Please have a look for any plagiarism.

    Is there a potential financial or other conflict of interest between yourself and the author(s)?

    No

    If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?

    Yes

  7. Version published to 10.1099/acmi.0.000645.v1 on Access Microbiology