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International Ophthalmology

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01-08-2019 | Original Paper

Ocular culture-proven endogenous endophthalmitis: a 5-year retrospective study of the microorganism spectrum at a tertiary referral center in Turkey

Authors: Hande Celiker, Haluk Kazokoglu

Published in: International Ophthalmology | Issue 8/2019

Abstract

Purpose

The aim of this study was to review the clinical profile of endogenous endophthalmitis (EE), including predisposing systemic conditions, responsible microorganisms, clinical presentations, and outcomes.

Methods

We reviewed data from 21 eyes of 15 patients diagnosed with EE and compared their clinical characteristics over a 5-year period. All patients were ocular fluid cultures proven. Generalized estimating equations (GEE) were used to analyze the effects of vitrectomy, diabetes, malignity, and clinical presentation condition on VA.

Results

Diabetes was the most common illness of EE patients (40.0%). In this geographical region, Pseudomonas aeruginosa (4.8%), Methicillin-sensitive Staphylococcus aureus (4.8%), Methicillin-resistant Staphylococcus aureus (4.8%), and Mycobacterium tuberculosis (4.8%) were identified as causative bacterial microorganisms (n = 5) in patients with EE, and Candida Species (71.4%) and Aspergillus (4.8%) were identified as causative fungal microorganisms (n = 16) in patients with EE in the vitreous specimens. Fungemia (76.2%) (especially yeasts) was the most common extraocular infection source among patients with EE. Fourteen eyes (66.7%) were managed with intravitreal injections of antimicrobial medicines, and seven eyes (33.3%) also underwent vitrectomy. GEE models revealed that logMAR final VA values were found as lower than initial VA assessments.

Conclusion

Depending on the different regions of the world, the characteristics of disease have been declared invariable. This study provides information about the clinical and microbiological profile of ocular culture-proven EE patients in a region of straddling the Asia and European continents. Aggressive medical and surgical treatment may result in favorable outcomes.

Sadiq MA, Hassan M, Agarwal A et al (2015) Endogenous endophthalmitis: diagnosis, management, and prognosis. J Ophthalmic Inflamm Infect 5:32. https://doi.org/10.1186/s12348-015-0063-y CrossRefPubMedPubMedCentral

Jackson TL, Paraskevopoulos T, Georgalas I (2014) Systematic review of 342 cases of endogenous bacterial endophthalmitis. Surv Ophthalmol 59:627–635. https://doi.org/10.1016/j.survophthal.2014.06.002 CrossRefPubMed

Okada AA, Johnson RP, Liles WC et al (1994) Endogenous bacterial endophthalmitis. Report of a 10-year retrospective study. Ophthalmology 101:832–838CrossRefPubMed

Shrader SK, Band JD, Lauter CB et al (1990) The clinical spectrum of endophthalmitis: incidence, predisposing factors, and features influencing outcome. J Infect Dis 162:115CrossRefPubMed

Relhan N, Forster RK, Flynn HW Jr (2018) Endophthalmitis: then and now. Am J Ophthalmol 187:xx–xxvii. https://doi.org/10.1016/j.ajo.2017.11.021 CrossRefPubMed

Jackson TL, Eykyn SJ, Graham EM et al (2003) Endogenous bacterial endophthalmitis: a 17-year prospective series and review of 267 reported cases. Surv Ophthalmol 48:403–423CrossRefPubMed

Schiedler V, Scott IU, Flynn HW Jr et al (2004) Culture-proven endogenous endophthalmitis: clinical features and visual acuity outcomes. Am J Ophthalmol 137:725–731. https://doi.org/10.1016/j.ajo.2003.11.013 CrossRefPubMed

Lingappan A, Wykoff CC, Albini TA et al (2012) Endogenous fungal endophthalmitis: causative organisms, management strategies, and visual acuity outcomes. Am J Ophthalmol 153(162–166):e1. https://doi.org/10.1016/j.ajo.2011.06.020 CrossRef

Binder MI, Chua J, Kaiser PK et al (2003) Endogenous endophthalmitis: an 18-year review of culture-positive cases at a tertiary care center. Medicine (Baltimore) 82:97–105CrossRef

10.

Sharma S, Padhi TR, Basu S et al (2014) Endophthalmitis patients seen in a tertiary eye care centre in Odisha: a clinico-microbiological analysis. Indian J Med Res 139:91–98PubMedPubMedCentral

11.

Lim HW, Shin JW, Cho HY et al (2014) Endogenous endophthalmitis in the Korean population: a 6-year retrospective study. Retina 34:592–602. https://doi.org/10.1097/IAE.0b013e3182a2e705 CrossRefPubMed

12.

Connell PP, O’Neill EC, Fabinyi D et al (2011) Endogenous endophthalmitis: 10-year experience at a tertiary referral centre. Eye (Lond) 25:66–72. https://doi.org/10.1038/eye.2010.145 CrossRef

13.

Gupta A, Orlans HO, Hornby SJ et al (2014) Microbiology and visual outcomes of culture-positive bacterial endophthalmitis in Oxford, UK. Graefes Arch Clin Exp Ophthalmol 252:1825–1830. https://doi.org/10.1007/s00417-014-2658-7 CrossRefPubMed

14.

Vaziri K, Pershing S, Albini TA et al (2015) Risk factors predictive of endogenous endophthalmitis among hospitalized patients with hematogenous infections in the United States. Am J Ophthalmol 159:498–504. https://doi.org/10.1016/j.ajo.2014.11.032 CrossRefPubMed

15.

Sridhar J, Flynn HW Jr, Kuriyan AE et al (2013) Endogenous fungal endophthalmitis: risk factors, clinical features, and treatment outcomes in mold and yeast infections. J Ophthalmic Inflamm Infect 3:60. https://doi.org/10.1186/1869-5760-3-60 CrossRefPubMedPubMedCentral

16.

Connell PP, O’Neill EC, Amirul Islam FM et al (2010) Endogenous endophthalmitis associated with intravenous drug abuse: 7-year experience at a tertiary referral center. Retina 30:1721–1725. https://doi.org/10.1097/iae.0b013e3181dd6db6 CrossRefPubMed

17.

Chen YJ, Kuo HK, Wu PC et al (2004) A 10-year comparison of endogenous endophthalmitis outcomes: an east Asian experience with Klebsiella pneumoniae infection. Retina 24:383–390CrossRefPubMed

18.

Sheu SJ (2017) Endophthalmitis. Korean J Ophthalmol 31:283–289. https://doi.org/10.3341/kjo.2017.0036 CrossRefPubMedPubMedCentral

19.

Cho H, Shin YU, Siegel NH et al (2016) Endogenous endophthalmitis in the American and Korean population: an 8-year retrospective study. Ocul Immunol Inflamm 26:1–8. https://doi.org/10.1080/09273948.2016.1195000 CrossRef

20.

Wong JS, Chan TK, Lee HM et al (2000) Endogenous bacterial endophthalmitis: an East Asian experience and a reappraisal of a severe ocular affliction. Ophthalmology 107:1483–1491CrossRefPubMed

21.

Ratra D, Saurabh K, Das D et al (2015) Endogenous endophthalmitis: a 10-year retrospective study at a tertiary hospital in South India. Asia Pac J Ophthalmol 4:286–292. https://doi.org/10.1097/APO.0000000000000120 CrossRef

22.

Paulus YM, Cheng S, Karth PA et al (2016) Prospective trial of endogenous fungal endophthalmitis and chorioretinitis rates, clinical course, and outcomes in patients with fungemia. Retina 36:1357–1363. https://doi.org/10.1097/iae.0000000000000919 CrossRefPubMed

23.

Durand ML (2013) Endophthalmitis. Clin Microbiol Infect 19:227–234. https://doi.org/10.1111/1469-0691.12118 CrossRefPubMedPubMedCentral

24.

Riddell JT, Comer GM, Kauffman CA (2011) Treatment of endogenous fungal endophthalmitis: focus on new antifungal agents. Clin Infect Dis 52:648–653. https://doi.org/10.1093/cid/ciq204 CrossRefPubMed

25.

Urtti A (2006) Challenges and obstacles of ocular pharmacokinetics and drug delivery. Adv Drug Deliv Rev 58:1131–1135. https://doi.org/10.1016/j.addr.2006.07.027 CrossRefPubMed

26.

Essman TF, Flynn HW Jr, Smiddy WE et al (1997) Treatment outcomes in a 10-year study of endogenous fungal endophthalmitis. Ophthalmic Surg Lasers 28:185–194PubMed

27.

Birnbaum FA, Gupta G (2016) The role of early vitrectomy in the treatment of fungal endogenous endophthalmitis. Retin Cases Brief Rep 10:232–235. https://doi.org/10.1097/ICB.0000000000000238 CrossRefPubMed

Title: Ocular culture-proven endogenous endophthalmitis: a 5-year retrospective study of the microorganism spectrum at a tertiary referral center in Turkey
Authors: Hande Celiker
Haluk Kazokoglu
Publication date: 01-08-2019
Publisher: Springer Netherlands
Published in: International Ophthalmology / Issue 8/2019
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-018-0997-9

2024 ASCO Annual Meeting

Springer Medicine

Ocular culture-proven endogenous endophthalmitis: a 5-year retrospective study of the microorganism spectrum at a tertiary referral center in Turkey

Abstract

Purpose

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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