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Fulltext Candida glabrata endophthalmitis following penetrating keratoplasty in a patient with negative donor rim culture

Muzaliha MN, Adil H, Ibrahim M, Shatriah I

BMC Ophthalmol, 2010;10:18.
PMID: 20537193 DOI: 10.1186/1471-2415-10-18

Candida glabrata endophthalmitis following keratoplasty is rare and almost always associated with positive donor rim culture.

Matched MeSH terms: Endophthalmitis/microbiology*; Endophthalmitis/pathology
Fulltext Enterococcus faecalis Endophthalmitis: Clinical Settings, Antibiotic Susceptibility, and Management Outcomes

Chen KJ, Lai CC, Chen HC, Chong YJ, Sun MH, Chen YP, et al.

Microorganisms, 2021 Apr 24;9(5).
PMID: 33923356 DOI: 10.3390/microorganisms9050918

Enterococcus faecalis is known to cause severe acute endophthalmitis and often leads to poor visual outcomes in most ophthalmic infections. This retrospective study is to report the clinical settings, antimicrobial susceptibility patterns, and visual outcome of E. faecalis endophthalmitis at a tertiary referral institution in Taoyuan, Taiwan. E. faecalis endophthalmitis was diagnosed in 37 eyes of 37 patients. Post-cataract surgery was the most common cause (n = 27, 73%), followed by bleb-associated (n = 3, 8%), endogenous (n = 2, 5%), corneal ulcer-related (n = 2, 5%), post-vitrectomy (n = 1, 3%), post-pterygium excision (n = 1, 3%), and trauma (n = 1, 3%). Visual acuities upon presentation ranged from counting fingers to no light perception. Pars plana vitrectomy with intravitreal antibiotics were performed in 23 eyes (76%) as primary or secondary treatment. All isolates (37/37, 100%) were sensitive to vancomycin, penicillin, ampicillin, and teicoplanin. Six of 22 eyes (27%) were resistant to high-level gentamicin (minimum inhibitory concentration > 500 mg/L). Final visual acuities were better than 20/400 in 11 eyes (30%), 5/200 to hand motions in 4 eyes (11%), and light perception to no light perception in 22 eyes (59%). Three eyes were treated with evisceration. Compared with non-cataract subgroups, the post-cataract subgroup showed a significant difference of better visual prognosis (p = 0.016).

Matched MeSH terms: Endophthalmitis
Fulltext Endogenous Endophthalmitis: A Five-year Review of Cases at the Raja Perempuan Zainab II Hospital, Kelantan, Malaysia

Michael NDB, Gunaseelan S, Tuan Jaffar TN, Noordin Z, Hussein A

Cureus, 2018 Jul 30;10(7):e3066.
PMID: 30280062 DOI: 10.7759/cureus.3066

Background Endogenous endophthalmitis (EE) is a type of intraocular inflammation secondary to hematogenous spread from a distant infective source within the body and usually occurs in immunocompromised patients. Objectives The aim of this study was to profile the patient characteristics, sources of infection, microbial profiles, and visual outcomes of patients with EE in Raja Perempuan Zainab II Hospital in Kelantan, Malaysia. Materials and methods Data from 18 eyes of 17 patients diagnosed with EE and admitted to the eye ward of Raja Perempuan Zainab II Hospital from January 2012 to December 2016 were retrospectively reviewed. Factors analyzed included patient age, sources of infection, visual acuity, microbial profiles, and treatment outcomes. Results The mean age of the 17 patients was 53.2 years. Twelve patients (70.6%) had EE of left eye, four (23.5%) had EE of right eye, and one (5.9%) had EE involving both the eyes. Sixteen patients (91.1%) had at least one predisposing condition, the most common of which was diabetes mellitus in 15 patients (88.2%). A source of infection was identified in 12 of the 17 patients, with urinary tract infection being the most common (five patients, 29.4%). Organisms were successfully isolated from 10 (58.8%) patients, including seven (41.2%) with Gram-negative and three (17.6%) with Gram-positive organisms. All patients presented with a visual acuity worse than 6/60. Nine (52.9%) patients underwent vitrectomy, with only two of these patients achieving a final visual acuity better than 6/60. Eleven patients became nonperceptive to light, with four of them undergoing evisceration. Conclusions EE is a rare but often devastating ocular condition. Visual outcomes are often poor especially in patients infected with Gram-negative bacteria.

Matched MeSH terms: Endophthalmitis
The Malaysian cataract surgery registry: incidence and risk factors of postoperative infectious endophthalmitis over a 7-year period

Wai YZ, Fiona Chew LM, Mohamad AS, Ang CL, Chong YY, Adnan TH, et al.

Int J Ophthalmol, 2018;11(10):1685-1690.
PMID: 30364221 DOI: 10.18240/ijo.2018.10.17

AIM: To report the incidence, risk factors and visual outcomes for postoperative endophthalmitis (POE) based on 7-year data from the Malaysian Ministry of Health Cataract Surgery Registry (MOH CSR).
METHODS: Data was collected from the web-based MOH CSR. All consecutive cataract surgery patients from 1st June 2008 to 31st December 2014 were identified. Exclusion criteria were traumatic cataract or previous ocular surgery. Demographic data, ocular co-morbidities, intraoperative details and postoperative visual acuity (VA) at final ophthalmological follow-up were noted. All eyes were taken for analysis. Subjects with POE were compared against subjects with no POE for risk factor assessment using multiple logistic regressions.
RESULTS: A total of 163 503 subjects were screened. The incidence of POE was 0.08% (131/163 503). Demographic POE risk factors included male gender (OR: 2.121, 95%CI: 1.464-3.015) and renal disease (OR: 2.867, 95%CI: 1.503-5.467). POE risk increased with secondary causes of cataract (OR: 3.562, 95%CI: 1.740-7.288), uveitis (OR: 11.663, 95%CI: 4.292-31.693) and diabetic retinopathy (OR: 1.720, 95%CI: 1.078-2.744). Intraoperative factors reducing POE were shorter surgical time (OR: 2.114, 95%CI: 1.473-3.032), topical or intracameral anaesthesia (OR: 1.823, 95%CI: 1.278-2.602), posterior chamber intraocular lens (PCIOL; OR: 4.992, 95%CI: 2.689-9.266) and foldable IOL (OR: 2.276, 95%CI: 1.498-3.457). POE risk increased with posterior capsule rupture (OR: 3.773, 95%CI: 1.915-7.432) and vitreous loss (OR: 3.907, 95%CI: 1.720-8.873). Postoperative VA of 6/12 or better was achieved in 15.27% (20/131) subjects with POE.
CONCLUSION: This study concurs with other studies regarding POE risk factors. Further strengthening of MOH CSR data collection process will enable deeper analysis and optimization of POE treatment.

Matched MeSH terms: Endophthalmitis
Fulltext Pasteurella canis Isolation following Penetrating Eye Injury: A Case Report

Rashid NK, Zam Z, Mdnoor SS, Siti-Raihan I, Azhany Y

Case Rep Ophthalmol Med, 2012;2012:362369.
PMID: 22606491 DOI: 10.1155/2012/362369

A 3-year-old boy presented with history of trauma to the left eye after he accidentally injured his eye with a broom stick made up from coconut skewers. There was history of cats as their pets but not dogs. Ocular examination revealed left superonasal conjunctival laceration and scleral perforation with prolapsed vitreous. Fundus examination showed minimal vitreous haemorrhage and flat retina. Conjunctiva swab at the wound site was sent for gram staining, culture, and sensitivity. He underwent scleral suturing, vitreous tap, and intravitreal injection of Ceftazidime and Amikacin. Vitreous tap was sent for gram stained, culture and sensitivity. Postoperatively, he was started empirically on IV Ciprofloxacin 160 mg BD, Guttae Ciprofloxacin, and Guttae Ceftazidime. Conjunctiva swab grew Pasteurella canis which was sensitive to all Beta lactams, Ciprofloxacin, Chloramphenicol, and Aminoglycoside. Post-operative was uneventful, absent signs of endophthalmitis or orbital cellulitis.

Matched MeSH terms: Endophthalmitis