Abstract
This study aimed to identify the microbial etiology of infectious endophthalmitis and to determine the antibacterial susceptibilities of bacterial isolates at an eye hospital in South China. A retrospective analysis was carried out on 330 patients with clinically diagnosed infectious endophthalmitis who underwent microbiological evaluation from January 2010 to December 2014. Of the 330 patients, 193 patients (58.5%) had posttraumatic endophthalmitis, 67 patients (20.3%) had postoperative endophthalmitis, 61 patients (18.5%) had endogenous endophthalmitis, and 9 patients (2.7%) had postcorneal infective endophthalmitis. Of the 105 cases (31.8%) of culture-positive endophthalmitis, 79 cases (75.2%) had bacterial growth and 26 cases (24.8%) had fungal growth. In posttraumatic endophthalmitis, Gram-positive bacteria were the predominant species, followed by Gram-negative bacteria and fungi. In endogenous endophthalmitis, Gram-negative bacteria were the predominant species, followed by fungi and Gram-positive bacteria. In postsurgical endophthalmitis, all infections were bacterial. However, in postcorneal infective endophthalmitis, all infections were fungal. Overall, levofloxacin showed the highest activity against bacterial isolates. There was a significant difference in the susceptibility to tobramycin between the isolates from posttraumatic and postoperative endophthalmitis (p < 0.05). The results of this study identify the microbial spectrum of infectious endophthalmitis in this clinical setting.
Highlights
Infectious endophthalmitis, a potentially sight-threatening disease, is characterized by marked inflammation of intraocular tissues and fluids
According to the possible sources of infectious endophthalmitis, the patients were divided into four groups as follows: endophthalmitis with trauma, endophthalmitis associated with microbial keratitis, endogenous endophthalmitis, and endophthalmitis with postoperative infection after sterile ocular surgery, including cataract surgeries, vitrectomy, penetrating keratoplasty, scleral buckling, trabeculectomy, implantation of a glaucoma drainage device, and intravitreal injection
In our study of 330 patients with infectious endophthalmitis, most cases were associated with ocular trauma
Summary
Infectious endophthalmitis, a potentially sight-threatening disease, is characterized by marked inflammation of intraocular tissues and fluids. Infectious endophthalmitis can be divided into the broad categories exogenous and endogenous. Exogenous endophthalmitis is caused by inoculation of the eye by microorganisms from the external environment and most commonly occurs as a complication of ocular surgery or trauma. It results from the contagious spread of infectious microbes from the cornea. Endogenous endophthalmitis is caused by hematogenous spread of infectious organisms from distant sites in the body. Both categories of endophthalmitis lead to subsequent intraocular inflammation and potentially severe visual loss
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