2003 OMIG, Abstract 19

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The Reliability of Transport Medium for Corneal Ulcer Culture and Microbiological Investigation: A Clinical Comparison with Direct Plate Inoculation
Abha B Kumar, Vicky Cevallos, M Srinivasan, John P. Whitcher, Stephen D McCleod. Proctor Foundation and Department of Ophthalmology UCSF

Purpose: To compare the microbiologic yield of corneal ulcer cultures established by direct inoculation of blood agar plates, versus indirect inoculation via transport medium in the clinical setting.
Methods: One hundred and four consecutive corneal ulcers were cultured by direct inoculation onto standard media plates including blood agar plates. Samples were also held in transport media (Amies without charcoal) and then plated after 4 and 24 hrs.
Results: Of 104 consecutive patients evaluated for presumed infectious keratitis, corneal samples obtained by calcium alginate swab Gram or KOH stain, or culture by direct inoculation or via transport medium, yielded a positive result in 77 cases (74%); 31(40%) cases were bacterial and 46(60%) were fungal. For the 23 bacterial ulcers that yielded a positive culture result by direct inoculation, 22(96%) and 21(91%) yielded a positive result after 4 and 24 hrs in Amies medium respectively. For 35 fungal ulcers that yielded a positive culture result by direct inoculation, 29(83%) yielded a positive result after 4 or 24 hrs in Amies medium. Moreover, 4 of the 11 fungal ulcers identified by KOH that did a yield positive culture by direct inoculation did so after 4 or 24 hrs in Amies medium.
Conclusions: Amies transport media may be a useful alternative to direct inoculation for infectious corneal ulcers in the clinical setting.

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