All consecutive cases of presumed microbial
keratitis were cultured with both a
platinum spatula and
calcium alginate swab moistened with
trypticase soy broth. Ten (77%) of the 13 culture-proven
ulcers in this series showed a greater number of colonies and more confluent growth on the
agar plates inoculated with a moistened swab compared with a much lower yield obtained using a
platinum spatula. All culture-positive bacterial
ulcers showed growth when cultured with a swab. Two
ulcers that were partially treated before culturing yielded very light growth from those rows inoculated with a swab and no growth from those rows inoculated with a spatula. Two
ulcers showed equal growth between the two methods. One
ulcer (Actinomycetes-Streptomyces/Nocardia) had greater growth obtained with a spatula compared with a swab. This series demonstrated a significantly greater retrieval of organisms from bacterial
keratitis when a
calcium alginate swab moistened with
trypticase soy broth was used to rub the
ulcer and directly inoculate the solid
agar media. The single case of filamentous bacteria suggests that a spatula may yield better organism retrieval from
ulcers caused by filamentous organisms.