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Zhang X, Chen Z, Li X, Zhou Z, Boost M, Huang T, Zhou X. Management and Prognosis of Acute Post-Cataract Surgery Endophthalmitis: A 10-Year Retrospective Analysis in Eastern China. Antibiotics (Basel) 2023; 12:1670. [PMID: 38136704 PMCID: PMC10740642 DOI: 10.3390/antibiotics12121670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Acute post-cataract surgery endophthalmitis (APSE) is a serious vision-threatening complication of cataract surgery. Analysis of the management and prognosis in cases of APSE may provide better guidance for future treatment. Fifty-six patients (56 eyes) diagnosed with APSE between 2013 and 2022 were retrospectively reviewed. The incidence of APSE rate was 0.020% (95% CI: 0.011-0.029%). Intraocular cultures were positive in 18 (32.1%) cases, with 21 organisms isolated. Coagulase-negative staphylococci was the predominant isolate (12/21; 57.1%). The time from surgery to the onset of endophthalmitis was 7 days (interquartile range: 3-16) in patients with good best-corrected visual acuity (BCVA) (≥20/70) and 3 days (interquartile range: 1-8) in those with poor BCVA (<20/70). Multivariate linear regression analysis revealed that initial BCVA (logMAR) (p < 0.001), time from onset to initial intravitreal antibiotics (IVAs) (p < 0.001), and positive culture of highly virulent pathogens (p = 0.018) displayed significantly positive associations with the final BCVA (logMAR). Adjunctive use of intravitreal corticosteroids and systemic antibiotics were unrelated to a favorable final BCVA. In conclusion, the severity of the visual condition at baseline, as well as delayed treatment, are risk factors for poor visual outcomes in APSE.
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Affiliation(s)
- Xiuwen Zhang
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (X.Z.); (X.L.)
| | - Zhi Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China;
- NHC Key Laboratory of Myopia, Fudan University, Shanghai 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Xiaoxia Li
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (X.Z.); (X.L.)
| | - Zimei Zhou
- Department of Ophthalmology, BronxCare Health System, Bronx, NY 10456, USA;
| | - Maureen Boost
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China;
| | - Taomin Huang
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (X.Z.); (X.L.)
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China;
- NHC Key Laboratory of Myopia, Fudan University, Shanghai 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
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Jiang X, Wan Y, Yuan H, Zhao L, Sun M, Xu Y, Xin X, Dong J, Hu D, Chen D, Li X. Incidence, Prophylaxis and Prognosis of Acute Postoperative Endophthalmitis After Cataract Surgery: A Multicenter Retrospective Analysis in Northern China from 2013 to 2019. Infect Drug Resist 2022; 15:4047-4058. [PMID: 35924017 PMCID: PMC9342430 DOI: 10.2147/idr.s332997] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 07/20/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To investigate the incidence of acute postoperative endophthalmitis (POE) after cataract surgery in Northern China from 2013 to 2019, evaluate the efficacy of prophylaxis and analyze the predictors of visual prognosis among POE patients. Methods The study was conducted as a retrospective multi-center research, with seven hospitals in Northern China enrolled. The diagnosis of acute-onset POE was made on the basis of clinical manifestations within six weeks after initial surgery. By reviewing electronic medical system, the number of cataract surgeries and acute POE cases were recorded to estimate the overall incidence and incidences by different years and hospitals. Perioperative measures for preventing infection in different hospitals were collected. The correlations between unfavorable final vision and potential factors including basic information and clinical characteristics were examined to determine the predictive factors for final visual prognosis. Results Of 72,255 cataract surgeries performed during seven years in the seven hospitals, 19 cases developed acute POE, yielding an overall incidence of 0.026%. The average incidence of acute POE among seven hospitals significantly declined annually during the past 7 years (p = 0.021). In Hospital-D, the incidence of acute POE significantly decreased after the application of 0.5% povidone-iodine (PVP-I) for conjunctival washing (p = 0.003). Two hospitals adopting tobramycin in the irrigation solution achieved a significant lower incidence of POE than the other hospitals (p = 0.044). The positive rate of pathogen culture was just 17.6% (3/19). Patients with presenting BCVA of CF or better were more likely to present with unfavorable final vision than those with worse presenting BCVA (p = 0.003). Conclusion The overall incidence of acute POE after cataract surgery from 2013 to 2019 in Northern China was 0.026%, and the incidence declined annually over the period. Presenting BCVA could be a significant prognosis factor for predicting the final visual outcomes of acute POE patients.
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Affiliation(s)
- Xiaodan Jiang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, People’s Republic of China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Yu Wan
- Department of Ophthalmology, Peking University Third Hospital, Beijing, People’s Republic of China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Hao Yuan
- Department of Ophthalmology, Peking University Third Hospital, Beijing, People’s Republic of China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Liming Zhao
- Department of Ophthalmology, Beijing Fengtai Hospital, Beijing, People’s Republic of China
| | - Min Sun
- Department of Ophthalmology, Huabei Petroleum General Hospital, Renqiu, Hebei, People’s Republic of China
| | - Yanhui Xu
- Department of Ophthalmology; Hebei Provincial Eye Hospital, Xingtai, Hebei, People’s Republic of China
| | - Xiangyang Xin
- Department of Ophthalmology, Inner Mongolia Baogang Hospital, Baotou, Inner Mongolia, People’s Republic of China
| | - Jing Dong
- Department of Ophthalmology, the First Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia, People’s Republic of China
| | - Die Hu
- Department of Ophthalmology, Baoding Zhuozhou GEM Flower Hospital, Zhuozhou, Hebei, People’s Republic of China
| | - Dongmei Chen
- Department of Ophthalmology, Baoding GEM Flower Eastern Hospital, Zhuozhou, Hebei, People’s Republic of China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, People’s Republic of China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, People’s Republic of China
- Correspondence: Xuemin Li, Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, No. 49 Huayuan North Road, Haidian District, Beijing, 100191, People’s Republic of China, Tel +86 10 8226 6312, Fax +86 10 8208 9951, Email
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Kitsche M, Herber R, Pillunat LE, Terai N. Clinical and visual outcome of endophthalmitis patients: a single-center experience. Graefes Arch Clin Exp Ophthalmol 2019; 258:183-189. [PMID: 31637487 DOI: 10.1007/s00417-019-04480-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 08/15/2019] [Accepted: 09/13/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To report the clinical and visual outcome and the therapeutical management in a large cohort of endophthalmitis patients. METHODS In a monocentric, observational study, we retrospectively analyzed the data of all patients with endophthalmitis who were referred to the department of ophthalmology of the Carl Gustav Carus Hospital Dresden between 2006 and 2018. RESULTS In total, data of 104 patients (49 female, 55 male) were included in the present analysis. The most frequent clinical scenario for endophthalmitis was postcataract surgery (30.8%). The most frequent treatment at presentation was a pars plana vitrectomy (ppV) in 42 patients, followed by an intravitreal antibiotic in 41 patients. Out of 41 patients who received an intravitreal antibiotic, 35 patients (85%) needed additional treatment. In contrast, out of 42 patients who received a ppV as the initial treatment, 19 patients (42%) needed additional therapy, which was significantly different (p < 0.0001). The best presenting visual acuity improved significantly after treatment (p < 0.0001). CONCLUSION The results of the present study suggest that, compared with an intravitreal antibiotic, a ppV as the initial therapy of endophthalmitis might reduce the number of additional treatments. From our data, it can be hypothesized that a ppV should be performed as early as possible to achieve the best visual outcome in most endophthalmitis patients. Prospective studies are now needed to address this issue in greater detail and to confirm our findings.
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Affiliation(s)
- Marcel Kitsche
- Department of Ophthalmology, Carl Gustav Carus University Hospital Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Robert Herber
- Department of Ophthalmology, Carl Gustav Carus University Hospital Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Lutz E Pillunat
- Department of Ophthalmology, Carl Gustav Carus University Hospital Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Naim Terai
- Department of Ophthalmology, Carl Gustav Carus University Hospital Dresden, Fetscherstraße 74, 01307, Dresden, Germany
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Sahinoglu-Keskek N, Pelit A. Intracameral moxifloxacin for prophylaxis of postoperative endophthalmitis. SPEKTRUM DER AUGENHEILKUNDE 2017. [DOI: 10.1007/s00717-017-0350-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kessel L, Flesner P, Andresen J, Erngaard D, Tendal B, Hjortdal J. Antibiotic prevention of postcataract endophthalmitis: a systematic review and meta-analysis. Acta Ophthalmol 2015; 93:303-17. [PMID: 25779209 PMCID: PMC6680152 DOI: 10.1111/aos.12684] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 01/12/2015] [Indexed: 11/30/2022]
Abstract
Endophthalmitis is one of the most feared complications after cataract surgery. The aim of this systematic review was to evaluate the effect of intracameral and topical antibiotics on the prevention of endophthalmitis after cataract surgery. A systematic literature review in the MEDLINE, CINAHL, Cochrane Library and EMBASE databases revealed one randomized trial and 17 observational studies concerning the prophylactic effect of intracameral antibiotic administration on the rate of endophthalmitis after cataract surgery. The effect of topical antibiotics on endophthalmitis rate was reported by one randomized trial and one observational study. The quality and design of the included studies were analysed using the Cochrane risk of bias tool. The quality of the evidence was evaluated using the GRADE approach. We found high-to-moderate quality evidence for a marked reduction in the risk of endophthalmitis with the use of intracameral antibiotic administration of cefazolin, cefuroxime and moxifloxacin, whereas no effect was found with the use of topical antibiotics or intracameral vancomycin. Endophthalmitis occurred on average in one of 2855 surgeries when intracameral antibiotics were used compared to one of 485 surgeries when intracameral antibiotics were not used. The relative risk (95% CI) of endophthalmitis was reduced to 0.12 (0.08; 0.18) when intracameral antibiotics were used. The difference was highly significant (p < 0.00001). Intracameral antibiotic therapy is the best choice for preventing endophthalmitis after cataract surgery. We did not find evidence to conclude that topical antibiotic therapy prevents endophthalmitis.
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Affiliation(s)
- Line Kessel
- Department of OphthalmologyCopenhagen University Hospital GlostrupGlostrupDenmark
- Danish Health and Medicines AuthoritiesCopenhagenDenmark
| | | | | | - Ditte Erngaard
- Department of OphthalmologyNæstved HospitalNæstvedDenmark
| | - Britta Tendal
- Danish Health and Medicines AuthoritiesCopenhagenDenmark
| | - Jesper Hjortdal
- Department of OphthalmologyAarhus University Hospital NBGAarhusDenmark
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Lansingh VC, Eckert KA, Strauss G. Benefits and risks of immediately sequential bilateral cataract surgery: a literature review. Clin Exp Ophthalmol 2015; 43:666-72. [PMID: 25824813 DOI: 10.1111/ceo.12527] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 03/23/2015] [Indexed: 11/28/2022]
Abstract
Immediately sequential bilateral cataract surgery (ISBCS) is a highly contended issue in ophthalmology, mainly due to the risk of bilateral endophthalmitis and financial penalties that many ophthalmologists face when performing simultaneous cataract surgeries. The purpose of this review is to understand the current status of the knowledge of ISBCS, mainly its benefits and risks and how they compare with the standard of care, delayed sequential bilateral cataract surgery. Evidence, although limited, increasingly supports ISBCS for providing faster rehabilitation, improved visual outcomes, and cost and time savings. Evidence does not support the fear of bilateral endophthalmitis resulting from the simultaneous procedure. However, stronger and greater evidence is needed before ISBCSs can be considered the standard of care. Where ISBCS can potentially create the most beneficial impact is in public eye health programmes in developing countries, but this has not yet been explored.
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Affiliation(s)
- Van C Lansingh
- Instituto Mexicano de Oftalmología Circuito Exterior Estadio Corregidora S/N, Querétaro, Querétaro, Mexico.,Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennesee, USA.,HelpMeSee, New York, New York, USA
| | - Kristen A Eckert
- Independent Consultant in Prevention of Blindness, Tapachula, Chiapas, Mexico
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Kim JH, Kong SJ, Kim JW, Lim TH, Choi KY, Cho BJ. Efficacy and Safety of Immediate Sequential Bilateral Cataract Surgery. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.12.1854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kocak I, Kocak F, Teker B, Aydin A, Kaya F, Baybora H. Evaluation of bacterial contamination rate of the anterior chamber during phacoemulsification surgery using an automated microbial detection system. Int J Ophthalmol 2014; 7:686-8. [PMID: 25161944 DOI: 10.3980/j.issn.2222-3959.2014.04.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 09/09/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To assess the incidence of anterior chamber bacterial contamination during phacoemulsification surgery using an automated microbial detection system (BacT/Alert). METHODS Sixty-nine eyes of 60 patients who had uneventful phacoemulsification surgery, enrolled in this prospective study. No prophylactic topical or systemic antibiotics were used before surgery. After antisepsis with povidone-iodine, two intraoperative anterior chamber aqueous samples were obtained, the first whilst entering anterior chamber, and the second at the end of surgery. BacT/Alert culture system was used to detect bacterial contamination in the aqueous samples. RESULTS Neither aqueous samples obtained at the beginning nor conclusion of the surgery was positive for microorganisms on BacT/Alert culture system. The rate of bacterial contamination during surgery was 0%. None of the eyes developed acute-onset endophthalmitis after surgery. CONCLUSION In this study, no bacterial contamination of anterior chamber was observed during cataract surgery. This result shows that meticulous surgical preparation and technique can prevent anterior chamber contamination during phacoemulsification cataract surgery.
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Affiliation(s)
- Ibrahim Kocak
- Nisa Hospital, Fatih cad, Cobancesme mah, Bahcelievler, Istanbul 34196, Turkey
| | - Funda Kocak
- Clinical Microbiology and Infectious Diseases, Basaksehir state hospital, Basaksehir, Istanbul 34306, Turkey
| | - Bahri Teker
- Nisa Hospital, Fatih cad, Cobancesme mah, Bahcelievler, Istanbul 34196, Turkey
| | - Ali Aydin
- Nisa Hospital, Fatih cad, Cobancesme mah, Bahcelievler, Istanbul 34196, Turkey ; Department of Ophthalmology, Medipol University Hospital, Bagcılar, Istanbul 34214, Turkey
| | - Faruk Kaya
- Nisa Hospital, Fatih cad, Cobancesme mah, Bahcelievler, Istanbul 34196, Turkey
| | - Hakan Baybora
- Nisa Hospital, Fatih cad, Cobancesme mah, Bahcelievler, Istanbul 34196, Turkey
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Galvis V, Tello A, Sánchez MA, Camacho PA. Cohort study of intracameral moxifloxacin in postoperative endophthalmitis prophylaxis. OPHTHALMOLOGY AND EYE DISEASES 2014; 6:1-4. [PMID: 24526838 PMCID: PMC3921022 DOI: 10.4137/oed.s13102] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 11/21/2013] [Accepted: 12/02/2013] [Indexed: 11/15/2022]
Abstract
We conducted a cohort study to evaluate post-cataract surgery endophthalmitis rates in relation to prophylactic intracameral moxifloxacin administration. A total of 2332 patients (2674 eyes) who underwent phacoemulsification by a single surgeon from January 2007 through December 2012 were included in the study. A total of 1056 eyes did not receive intracameral prophylactic moxifloxacin and the antibiotic was injected in 1618 eyes. The incidence of presumed postoperative endophthalmitis in the 2 groups was calculated. The rate of presumed infectious endophthalmitis after cataract surgery between January 2007 and June 2009 (without intracameral moxifloxacin) was 0.094%. The rate in the second period, from July 2009 to December 2012 (with prophylactic intracameral moxifloxacin), was 0%. In our patients, a decline in the incidence of presumed infectious postoperative endophthalmitis appeared to be associated with the application of intracameral moxifloxacin.
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Affiliation(s)
- Virgilio Galvis
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Santander, Colombia. ; Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia
| | - Alejandro Tello
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Santander, Colombia. ; Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia
| | | | - Paul Anthony Camacho
- Fundación Oftalmológica de Santander (FOSCAL). Floridablanca, Santander, Colombia
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Fernández-Rubio ME, Cuesta-Rodríguez T, Urcelay-Segura JL, Cortés-Valdés C. [Beta-lactamic antibiotics allergy in cataract surgery. Prevalence and preoperative characteristics of allergic patients]. ACTA ACUST UNITED AC 2013; 89:92-8. [PMID: 24360913 DOI: 10.1016/j.oftal.2013.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 08/22/2013] [Accepted: 10/28/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe the proportion of patients allergic to β-lactam antibiotics and the prevalence of preoperative conjunctival bacteria among those undergoing cataract surgery in our area. METHOD Retrospective cross-sectional study of prevalence of β-lactam allergic patients consecutively scheduled for cataract surgery from 11 July 2005 to November 2012. For studying the prevalence of conjunctival bacteria and clinical characteristics in the patients' preoperative examination, those under 18 years and those with cataract surgery combined with other eye surgeries were excluded. Data from the first preoperative examination of the remaining patients were selected. Clinical data were extracted from the database generated in the evaluation made for anesthetic purposes, and the microbiological data from the laboratory database. Both bases were linked through a patient history code. A comparison was made between the prevalence of conjunctival bacteria and clinical characteristics in allergic and non-allergic patients. RESULTS From 12,409 adults selected for the bacteriological study, 862 (6.96%) were allergic to β-lactams, their mean age (74.45 years) was higher than that of the non-allergic (P=.005). The proportion of women (71.4%) in the allergic patient group was much higher than that of men. The prevalence of pathogenic bacteria (especially Bacillus spp and Pseudomonas aeruginosa), lung disease and heart failure, was higher in allergic patients. CONCLUSIONS The prevalence of allergy to β-lactams in this study is within the range described in other populations. The higher prevalence of pathogenic bacteria and the predominance of women in those allergic to β-lactams are useful data to guide their surgical prophylaxis.
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Affiliation(s)
- M E Fernández-Rubio
- Departamento de Oftalmología, Instituto Oftálmico, Laboratorio de Análisis Clínicos, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | - T Cuesta-Rodríguez
- Departamento de Oftalmología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - J L Urcelay-Segura
- Departamento de Oftalmología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - C Cortés-Valdés
- Departamento de Oftalmología, Hospital General Universitario Gregorio Marañón, Madrid, España
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Mshangila B, Paddy M, Kajumbula H, Ateenyi-Agaba C, Kahwa B, Seni J. External ocular surface bacterial isolates and their antimicrobial susceptibility patterns among pre-operative cataract patients at Mulago National Hospital in Kampala, Uganda. BMC Ophthalmol 2013; 13:71. [PMID: 24238071 PMCID: PMC3830561 DOI: 10.1186/1471-2415-13-71] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 11/12/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Endophthalmitis is a severe complication of cataract surgery which leads to high ocular morbidity and visual loss even with antibiotic treatment. Bacterial ocular floras are the implicated causative agents. This study was undertaken to evaluate the external ocular surface bacterial isolates and their antimicrobial susceptibility patterns among pre-operative cataract patients at Mulago National Hospital. METHODS This cross sectional study enrolled consecutively 131 patients scheduled for routine cataract surgery in the Department of Ophthalmology at Mulago National Hospital in Kampala, Uganda. Eyelid margin and conjunctival swabs were collected and processed using standard microbiological procedures to identify bacterial isolates and their respective antimicrobial susceptibility patterns. RESULTS Of 131 patients involved (mean age 63.3 ± 14.5 years), 54.2% (71/131) were females. The eyelid margin and conjunctival samples were culture positive in 59.5% (78/138) and 45.8% (60/138) respectively. The most common organisms identified were Coagulase-negative Staphylococci (CoNS) [65.9% (91/138)] and Staphylococcus aureus [21.0% (29/138)]. CoNS showed the highest resistance to tetracycline (58.2%, 53/91) and erythromycin (38.5%, 35/91), whereas in S. aureus the resistance to tetracycline and erythromycin were 55.2% (16/29) and 31.0% (9/29) respectively. Methicillin resistant CoNS (MRS) and Methicillin resistance S. aureus (MRSA) were 31.9% (29/91) and 27.6% (8/29) respectively. There were low resistance rates for CoNS, S. aureus and other bacterial isolates to ciprofloxacin (11.1%-24.2%), gentamicin (5.6-31.0%), tobramycin (17.2% -25.3%) and vancomycin (0.0%). CONCLUSION CoNS and S. aureus are the most common bacterial isolates found on the external ocular surface of the pre-operative cataract patients. Ciprofloxacin, gentamicin, tobramycin and vancomycin showed the lowest resistance rates to all bacterial isolates, therefore may be used to reduce bacteria load in the conjunctiva sac among cataract patients prior to surgery.
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Affiliation(s)
| | | | | | | | | | - Jeremiah Seni
- Department of Medical Microbiology, Makerere University College of Health Sciences, P,O, Box 7072, Kampala, Uganda.
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