Analysis of pathogenic factors and clinical features of infectious endophthalmitis

Abstract

Purpose To analyze the etiology and etiological characteristics of infectious endophthalmitis, improve the cognition of infectious endophthalmitis, guide rational choices of early-stage empirical drugs in clinical practice. Methods A cross-sectional study. The medical records of 248 patients diagnosed with endophthalmitis in Shanxi Eye Hospital from January 2016 to December 2020 were reviewed and analyzed. Rrsults Of all patients with infectious endophthalmitis, 185 were male and 63 were female, aged 4 to 87 (51.28±18.33) years. Open eye trauma and intraocular surgery were the main causative factors. Positive case of specimen culture was detected in 93 cases, accounting for 42.66%. Regarding the composition of the pathogenic bacterial spectrum, 77 cases were Gram-positive, 17 were Gram-negative, 1 was fungal, and 1 was viral. Staphylococcus epidermidis, the most common pathogen, accounted for 33.33%, mainly in traumatic endophthalmitis and postoperative endophthalmitis, and was extremely sensitive to vancomycin. The Gram-positive bacteria were highly sensitive to vancomycin and relatively sensitive to levofloxacin . Gram-negative bacteria were highly sensitive to levofloxacin . 10.89% of patients with visual acuity > 0.02 at admission and 24.60% at discharge, the difference was statistically significant (c2=17.449, P < 0.001). Conclusion The main causative factors of infectious endophthalmitis were open eye trauma and intraocular surgery. Vitrectomy and/or intravitreal injection were the main effective treatments. The most common pathogen was staphylococcus epidermidis. The vast majority of pathogen were Gram-positive. Levofloxacin was sensitive to both Gram-positive and Gram-negative bacteria. Vancomycin was highly sensitive to Gram-positive bacteria. Levofloxacin was highly sensitive to Gram-negative bacteria. Clarifying the different causative factors and etiological characteristics of infectious endophthalmitis can helps to provide appropriate clinical treatment.