Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Hyderabad, India.
Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University, Detroit, Michigan, USA.
Curr Eye Res. 2020 Feb;45(2):184-189. doi: 10.1080/02713683.2019.1662057. Epub 2019 Sep 13.
: Microbiological investigations of vitreous fluid have often failed to detect the causative agent in infectious endophthalmitis resulting in a clinical dilemma. D-Lactate is a byproduct of bacterial metabolism, and its accumulation in sterile body fluids indicates bacterial infection. The aim of the study was to evaluate the measurement of vitreous fluid D-lactate for the diagnosis of infectious endophthalmitis and to define an optimal D-lactate concentration for the differentiation from non-infectious samples.: Vitreous samples of 41 patients clinically diagnosed as endophthalmitis and 20 patients with non-infectious disorders, as controls, between October 2018 and February 2019 were included in the study. D-lactate levels were determined by a D-lactate colorimetric assay kit (MAK058 Sigma-Aldrich) and the receiver operating characteristic curves (ROC) of D-lactate were calculated. The clinical finding of D-lactate production in bacterial endophthalmitis was also verified in a mouse model of bacterial endophthalmitis.: Of the 41 patients included in the infectious group, 25 had culture-positive infections of which 13/25 were gram-positive organisms and 12/25 grew gram-negative bacilli. Based on the ROC curve, the sensitivity of D-lactate was found to be 80% and specificity 100% and a cut-off value of above 47.06 ng/µl for D-lactate was defined as positive or true infectious in vitreous samples for diagnosis of endophthalmitis. , a mouse model of bacterial endophthalmitis showed the significant production of D-lactate levels in retina and vitreous. Interestingly the levels were elevated in Gram-negative infections compared to Gram-positive bacterial endophthalmitis.: Our clinical and mouse model data showed that vitreous fluid D-lactate could be used as a bacterial-specific biomarker in the diagnosis of most infectious endophthalmitis and could be implemented for the evaluation of treatment success.
: 玻璃体液的微生物学研究常常未能检测出导致感染性眼内炎的病原体，这导致了临床困境。D-乳酸是细菌代谢的副产物，其在无菌体液中的积累表明存在细菌感染。本研究旨在评估玻璃体液 D-乳酸测量在诊断感染性眼内炎中的作用，并确定区分非感染性样本的最佳 D-乳酸浓度。
: 2018 年 10 月至 2019 年 2 月，本研究纳入了 41 例临床诊断为眼内炎的患者和 20 例非感染性疾病患者的玻璃体样本。通过 D-乳酸比色法试剂盒（MAK058 Sigma-Aldrich）测定 D-乳酸水平，并计算 D-乳酸的受试者工作特征曲线（ROC）。还在细菌性眼内炎的小鼠模型中验证了细菌性眼内炎中 D-乳酸产生的临床发现。
: 在感染组的 41 例患者中，有 25 例培养阳性感染，其中 13/25 为革兰阳性菌，12/25 为革兰阴性杆菌。根据 ROC 曲线，D-乳酸的敏感性为 80%，特异性为 100%，D-乳酸>47.06ng/µl 定义为玻璃体样本中阳性或真性感染，用于诊断眼内炎。有趣的是，与革兰阳性细菌性眼内炎相比，革兰阴性感染的 D-乳酸水平升高。
: 我们的临床和小鼠模型数据表明，玻璃体液 D-乳酸可作为大多数感染性眼内炎的细菌特异性生物标志物，并可用于评估治疗效果。
