Clinical Presentation, Microbiologic Profile and Factors Predicting Outcomes in Bacillus Endophthalmitis

Dave, Vivek Pravin; Pathengay, Avinash; Budhiraja, Ina; Sharma, Savitri; Pappuru, Rajeev Reddy; Tyagi, Mudit; Narayanan, Raja; Jalali, Subhadra; Chhablani, Jay; Das, Taraprasad

doi:10.1097/iae.0000000000001640

Cited by 10 publications

(4 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A case series of 86 Bacillus isolates were all susceptible to gentamicin, with 1 resistant to ciprofloxacin and 5 resistant to vancomycin. 70 A similar variation in strategy can be seen in India, where gram-negative endophthalmitis is more common and susceptibility remains higher for amikacin than for ceftazidime. 67…”

Section: Treatment Susceptibility and Resistancementioning

confidence: 84%

Infectious Endophthalmitis: Trends in Microbiology, Management, and Surgical Techniques

Keffer

Chin

Almeida³

2018

Journal of VitreoRetinal Diseases

View full text Add to dashboard Cite

The purpose of this review is to provide an update on etiologies, preventive practices, management options, and surgical techniques for infectious endophthalmitis. Methods: A literature search was conducted for studies published over the past 5 years. Results: Endophthalmitis continues to be an uncommon but dangerous complication following cataract surgery. Recently, intravitreal injections have become heavily utilized as a treatment for various ocular diseases, leading to a greater incidence of postinjection infections. Likewise, long-term risk of endophthalmitis should always be a consideration following glaucoma surgery and implanted drainage devices. Although significant overlap exists for causative organisms among the different etiologies, more targeted studies are needed to better optimize treatment. There has been a lack of updates to treatment guidelines since the Endophthalmitis Vitrectomy Study was published in 1995. Despite promising outcomes seen with newer surgical techniques, the lack of randomized clinical trials represents a major barrier to widespread implementation of these approaches. Conclusions: Povidone-iodine prophylaxis remains the primary evidence-based technique for decreasing the rates of endophthalmitis following intraocular procedures. Intracameral antibiotics have gained momentum in recent years and represent a step forward in mitigating the risk of infection with cataract surgery, although some debate still exists. Newer surgical techniques for vitrectomy that improve visualization, minimize surgical trauma, and decrease operative time would benefit from large-scale randomized trials.

show abstract

Section: Treatment Susceptibility and Resistancementioning

confidence: 84%

Infectious Endophthalmitis: Trends in Microbiology, Management, and Surgical Techniques

Keffer

Chin

Almeida³

2018

Journal of VitreoRetinal Diseases

View full text Add to dashboard Cite

show abstract

“…Functional success was defined as a vision of ≥20/400 at the last visit. [ 4 8 9 10 11 ] Evisceration was performed in cases that developed a painful blind eye, had a prolapse of intraocular contents due to a corneal perforation, or showed progression to panophthalmitis.…”

Section: Methodsmentioning

confidence: 99%

Endophthalmitis with opaque cornea managed with primary endoscopic vitrectomy and secondary keratoplasty: Presentations and outcomes

Dave

Pappuru

Khader

et al. 2020

Indian J Ophthalmol

Self Cite

View full text Add to dashboard Cite

Purpose: To describe the outcomes of endophthalmitis with opaque cornea managed with primary endoscopic vitrectomy and secondary keratoplasty. Methods: Retrospective consecutive interventional case series. All cases of endophthalmitis with opaque cornea which underwent endoscopic vitrectomy followed by secondary keratoplasty were analyzed. The study period was from Jan 2015 to March 2019. The outcome measures were resolution of infection, the magnitude of unnecessary keratoplasties avoided and corneal graft survival. The final anatomic and functional outcomes were reported and compared with relevant literature. Results: Seventy-eight eyes of 78 patients underwent endoscopic pars plana vitrectomy for endophthalmitis with the opaque cornea, of these 14 eyes of 14 patients were deemed eligible for further corneal intervention and were included in the study. The mean age at presentation was 42.27 ± 21.6 years (median 36 years). Etiology-wise, eight cases (57.14%) were post-trauma, three cases (21.42%) post-keratoplasty, two cases (14.28%) were endogenous, and one case (7.14%) following corneal dermoid excision and wound melt. Culture positivity was in 5/14 (35.71%). The mean interval between endoscopic vitrectomy and keratoplasty was 5.42 ± 2.69 months (median 3.5 months). The mean follow-up noted was 20.42 ± 11.45 months (median 17.5 months). The infection resolved in 100% of cases. Unnecessary keratoplasties were avoided in 64/78 (82%) cases due to the primary endoscopic intervention. The favorable anatomic outcome was seen in 11/14 (78.57%) of cases and favorable functional outcome in 8/14 (57.14%) cases. Conclusion: Endoscopic vitrectomy allows for early intervention in endophthalmitis with the opaque cornea. This facilitates early settlement of infection, globe preservation, greater graft survival, and lesser repeat posterior segment procedures.

show abstract

“…Chocolate agar was incubated in 5% CO2 at 37°C. [78] The explanted IOL was plated in a chocolate agar plate separately.…”

Section: Methodsmentioning

confidence: 99%

Clinical presentations and comparative outcomes of primary versus deferred intraocular lens explantation in delayed-onset endophthalmitis

Dave

Pathengay

Sharma

et al. 2019

Indian J Ophthalmol

Self Cite

View full text Add to dashboard Cite

Purpose: To describe clinical presentations and comparative outcomes of primary versus deferred intraocular lens (IOL) explantation in delayed-onset endophthalmitis. Methods: In this retrospective study, a total of 77 eyes of 77 patients that were diagnosed clinically as delayed-onset endophthalmitis and underwent IOL explantation from January 1990 to January 2018 were included undiluted vitreous biopsy and IOL were subjected to microbiologic evaluation. Duration of symptoms, presenting visual acuity, organisms isolated, time to IOL explantation, time to endophthalmitis, resolution after explantation, number of repeat intravitreal injections, and final visual acuity were compared in the primary and the deferred IOL explantation groups. Results: There were primary and deferred IOL explantations. Interval between inciting event and endophthalmitis, between onset of symptoms to presentation, total follow-up, complication rate, and final visual acuity was comparable between the two groups. Median time to IOL explantation in the deferred group was 70 days. Between the primary and deferred IOL explantation groups the number of repeat intravitreal injections was 0.58 ± 0.86 and 2.62 ± 1.78 respectively, ( P < 0.0001, 95% confidence interval, CI 2.00–2.22); the number of days to resolution after IOL explantation was 35.16 ± 14.26 and 55.5 ± 8.24 respectively, ( P < 0.0001, 95% CI 15.22–25.45). Conclusion: Early IOL explantation in delayed-onset endophthalmitis causes faster clinical resolution and reduces the number of repeat intravitreal injections. Final visual improvement, however, may be unaffected.

show abstract

Clinical Presentation, Microbiologic Profile and Factors Predicting Outcomes in Bacillus Endophthalmitis

Abstract: Patients diagnosed with Bacillus endophthalmitis merit aggressive vitreous intervention guided by the culture-sensitivity report. Despite early and appropriate treat ment, the outcomes are generally poor.

Cited by 10 publications

References 20 publications

Infectious Endophthalmitis: Trends in Microbiology, Management, and Surgical Techniques

Infectious Endophthalmitis: Trends in Microbiology, Management, and Surgical Techniques

Endophthalmitis with opaque cornea managed with primary endoscopic vitrectomy and secondary keratoplasty: Presentations and outcomes

Clinical presentations and comparative outcomes of primary versus deferred intraocular lens explantation in delayed-onset endophthalmitis

Contact Info

Product

Resources

About