Bacterial conjunctivitis, caused by S. pneumoniae, S. aureus, and H. influenzae, is the most common type of infectious conjunctivitis. Inflammation of the cornea usually follows some type of trauma to the ocular surface. Postsurgical and posttraumatic endophthalmitis is often associated with Bacillus spp. and Enterobacteriaceae in addition to the aforementioned organisms.
Acute otitis media occurs in the form of a pustule and is often caused by S. aureus. Swimmer’s ear is related to maceration of the ear from swimming or hot, humid weather; it often is caused by P. aeruginosa. Otitis media often begins as a viral infection, with a bacterial infection occurring soon afterward. In children, the most common pathogens are S. pneumoniae, H. influenzae, and Moraxella catarrhalis.
Procedure for Eye Cultures
Observe standard precautions.
Purulent material from the lower conjunctival sac or inner canthus of the eye is collected on a sterile swab and placed in transport medium. Each eye should be cultured separately.
Scrapings of the cornea with a heat-sterilized platinum spatula directly onto the medium (blood or chocolate agar, brain–heart infusion medium for fungi, or thioglycolate broth) in cases of keratitis should be obtained by an ophthalmologist. For viral culture, the material is placed into viral transport broth.
Do not refrigerate specimens or transport on ice. Deliver to the laboratory as soon as possible.
Procedure for Ear Cultures
Observe standard precautions.
Cleanse the ear with a mild germicide to exclude contaminating skin flora in cases of external otitis.
Use a sterile swab or syringe and needle to collect middle ear fluid. Cultures from the mastoid usually are taken during surgery.
Do not refrigerate specimens. Label specimens with the patient’s name, date, and test(s) ordered and deliver to the laboratory as soon as possible.
Pretest Patient Care
Explain purpose of and procedure for the culture. Record signs and symptoms of ear infection, pain, redness, and drainage.
Follow guidelines in Chapter 1 for safe, effective, informed pretest care.
Posttest Patient Care
Review test results; report and record findings. Modify the nursing care plan as needed. Monitor the site of infection. Counsel the patient appropriately.
Follow guidelines in Chapter 1 for safe, effective, informed posttest care.