Abstract
Purposes
The aims of this study were to describe the bacterial isolates and treatment outcomes of endophthalmitis after cataract surgery at a referral centre in Northern Taiwan.
Methods
This was a retrospective, interventional, and observational series. Medical records were review of patients with clinical diagnosed, and/or culture-proven bacterial endophthalmitis at a tertiary referral centre in Northern Taiwan from January 2002 to December 2008. Treatment generally conformed to standard guidelines. Main outcome measurements were results of organism culture, antibiotic susceptibility of isolated bacteria, and visual acuity (VA) outcome.
Results
Thirty-four patients had positive cultures. A total of 55.9% of the culture-positive isolates were Gram negative and 44.1% were Gram positive. Pseudomonas aeruginosawas the most commonly isolated organism. Eighteen patients had final VA better than 5/200, and 41 had final VA worse than 5/200. In multiple linear regression analysis, female gender, presence of hypopyon, and worse baseline VA were significant independent predictors of worse visual outcome.
Conclusions
It was found that at a referral centre in Northern Taiwan, the majority of bacterial isolates were Gram negative in acute postoperative bacterial endophthalmitis after cataract surgery and P. aeruginosawas the most common bacterial isolate.
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References
Brain G, Taylor H . Cataract blindness—challenges for 21st century. Bull World Health Org 2001; 79 (3): 249–256.
West ES, Behrens A, McDonnell PJ, Tielsch JM, Schein OD . The incidence of endophthalmitis after cataract surgery among the US. Medicare population increased between 1994 and 2001. Ophthalmology 2005; 112 (8): 1388–1394.
Lloyd JC, Braga-Mele R . Incidence of postoperative endophthalmitis in a high-volume cataract surgicentre in Canada. Can J Ophthalmol 2009; 44 (3): 288–292.
Carrim ZI, Richardson J, Wykes WN . Incidence and visual outcome of acute endophthalmitis after cataract surgery—the experience of an eye department in Scotland. Br J Ophthalmol 2009; 93 (6): 721–725.
Lalitha P, Rajagopalan J, Prakash K, Ramasamy K, Prajna NV, Srinivasan M . Postcataract endophthalmitis in South India. Incidence and outcome. Ophthalmology 2005; 112 (11): 1885–1890.
Al-Mezaine HS, Kangave D, Al-Assiri A, Al-Rajhi AA . Acute-onset nosocomial endophthalmitis after cataract surgery: incidence, clinical features, causative organisms, and visual outcomes. J Cataract Refract Surg 2009; 35 (4): 643–649.
Endophthalmitis Vitrectomy Study Group. Results of the Endophthalmitis Vitrectomy Study: a randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Arch Ophthalmol 1995; 113 (12): 1479–1496.
Montan P, Lundström M, Stenevi U, Thorburn W . Endophthalmitis following cataract surgery in Sweden. The 1999–2001 national prospective survey. Acta Ophthalmol Scand 2005; 83 (1): 7–10.
Wong TY, Chee SP . The epidemiology of acute endophthalmitis after cataract surgery in an Asian population. Ophthalmology 2004; 111 (4): 699–705.
Haapala TT, Nelimarkka L, Saari JM, Ahola V, Saari KM . Endophthalmitis following cataract surgery in southwest Finland from 1987 to 2000. Graefes Arch Clin Exp Ophthalmol 2005; 243 (10): 1010–1017.
Mollan SP, Gao A, Lockwood A, Durrani OM, Butler L . Postcataract endophthalmitis: incidence and microbial isolates in a United Kingdom region from 1996 through 2004. J Cataract Refract Surg 2007; 33 (2): 265–268.
Recchia FM, Busbee BG, Pearlman RB, Carvalho-Recchia CA, Ho AC . Changing trends in the microbiological aspects of postcataract endophthalmitis. Arch Ophthalmol 2005; 123 (3): 341–346.
ESCRS Endophthalmitis Study Group. Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg 2007; 33 (6): 978–988.
Hollander DA, Vagefi MR, Seiff SR, Stewart JM . Bacterial endophthalmitis after resident-performed cataract surgery. Am J Ophthalmol 2006; 141 (5): 949–951.
Ohl CA, Pollack M . Infections due to pseudomonas species and related organisms. In: Braunwald E, Fauci AS, Kasper DL, Hauser SL (eds). Harrison's Principles of Internal Medicine, 15th ed., McGraw-Hill: New York, 2001, pp 963–970.
Anand AR, Therese KL, Madhavan HN . Spectrum of aetiological agents of postoperative endophthalmitis and antibiotics susceptibility of bacterial isolates. Indian J Ophthalmol 2000; 48 (2): 123–128.
Gupta A, Gupta V, Gupta A, Dogra MR, Pandav SS, Ray P et al. Spectrum and clinical profile of postcataract surgery endophthalmitis in North India. Indian J Ophthalmol 2003; 51: 139–145.
Pinna A, Usai D, Sechi LA, Zanetti S, Jesudasan NC, Thomas PA et al. An outbreak of post-cataract surgery endophthalmitis caused by pseudomonas aeruginosa. Ophthalmology 2009; 116 (12): 2321–2326.
Zaluski S, Clayman HM, Karsenti G, Bourzeix S, Tournemire A, Faliu B et al. Pseudomonas aeruginosa endophthalmitis caused by contamination of the internal fluid pathways of a phacoemulsifier. J Cataract Refract Surg 1999; 25 (4): 540–545.
Lauderdale TL, Clifford McDonald L, Shiau YR, Chen PC, Wang HY, Lai JF et al. TSAR participating hospitals. The status of antimicrobial resistance in Taiwan among Gram-negative pathogens: the Taiwan surveillance of antimicrobial resistance (TSAR) program, 2000. Diagn Microbiol Infect Dis 2004; 48 (3): 211–219.
Han DP, Wisniewski SR, Kelsey SF, Doft BH, Barza M, Pavan PR . Microbiologic yields and complication rates of vitreous needle aspiration versus mechanized vitreous biopsy in the Endophthalmitis Vitrectomy Study. Retina 1999; 19 (2): 98–102.
Chalita MR, Höfling-Lima AL, Paranhos Jr A, Schor P, Belfort Jr R . Shifting trends in in vitro antibiotic susceptibilities for common ocular isolates during a period of 15 years. Am J Ophthalmol 2004; 137 (1): 43–51.
Eifrig CW, Flynn Jr HW, Scott IU, Newton J . Acute-onset postoperative endophthalmitis: review of incidence and visual outcomes (1995–2001). Ophthalmic Surg Lasers 2002; 33 (5): 373–378.
Lalwani GA, Flynn Jr HW, Scott IU, Quinn CM, Berrocal AM, Davis JL et al. Acute-onset endophthalmitis after clear corneal cataract surgery (1996–2005). Clinical features, causative organisms, and visual acuity outcomes. Ophthalmology 2008; 115 (3): 473–476.
Kamalarajah S, Silvestri G, Sharma N, Sharma NK, Cole MD, Cran G et al. Surveillance of endophthalmitis following cataract surgery in the UK. Eye 2004; 18 (6): 580–587.
Eifrig CW, Scott IU, Flynn Jr HW, Miller D . Endophthalmitis caused by pseudomonas aeruginosa. Ophthalmology 2003; 110 (9): 1714–1717.
Kamalarajah S, Ling R, Silvestri G, Sharma NK, Cole MD, Cran G et al. Presumed infectious endophthalmitis following cataract surgery in the UK: a case-control study of risk factors. Eye (Lond) 2007; 21 (5): 580–586.
Kodjikian L, Beby F, Rabilloud M, Bruslea D, Halphen I, Fleury J et al. Influence of intraocular lens material on the development of acute endophthalmitis after cataract surgery? Eye (Lond) 2008; 22 (2): 184–193.
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Cheng, JH., Chang, YH., Chen, CL. et al. Acute endophthalmitis after cataract surgery at a referral centre in Northern Taiwan: review of the causative organisms, antibiotic susceptibility, and clinical features. Eye 24, 1359–1365 (2010). https://doi.org/10.1038/eye.2010.39
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DOI: https://doi.org/10.1038/eye.2010.39
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