Endophthalmitis Caused by Agrobacterium radiobacter

Pierre-Filho, Paulo de Tarso P.; Ribeiro, Ana Paula Y.; Passos, Elane D.; Torigoe, Marcelo; Vasconcellos, José Paulo C. De

doi:10.1080/00365540310012253

Cited by 11 publications

(16 citation statements)

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“…The present case series confirms that R. radiobacter is an opportunistic human pathogen occasionally responsible for acute postoperative endophthalmitis (18,19,24). The adherence of this bacterium to the intraocular lens during cataract surgery may promote development of endophthalmitis, as has been reported for Staphylococcus epidermidis (20).…”

supporting

confidence: 66%

“…The adherence of this bacterium to the intraocular lens during cataract surgery may promote development of endophthalmitis, as has been reported for Staphylococcus epidermidis (20). In contrast, none of the endophthalmitis patients from our series and previous reports (18,19,24) had underlying malignancy or were immunocompromised. The onset of symptoms after cataract surgery varied from 4 days (18) to 4 weeks (our case series), and this may partly depend on the bacterial inoculum leading to infection.…”

contrasting

confidence: 51%

“…The onset of symptoms after cataract surgery varied from 4 days (18) to 4 weeks (our case series), and this may partly depend on the bacterial inoculum leading to infection. Most patients suffered from acute endophthalmitis with severe symptoms (18,24), but a chronic endophthalmitis case was also reported (19). All patients recovered from R. radiobacter infection after intravitreal and systemic antibiotic therapy, but the final outcome varied from a total visual recovery to a near-complete loss of visual acuity in the affected eye (references 18, 19, and 24 and the present study).…”

mentioning

confidence: 81%

“…Our three endophthalmitis cases were geographically and temporally unrelated and were diagnosed and treated in three different hospitals (Grenoble, Dijon, and Lyon) in France. In addition, no series of endophthalmitis cases caused by R. radiobacter reported in the literature (18,19,24) corresponded to an epidemic situation.…”

mentioning

confidence: 99%

“…Because R. radiobacter is a soil organism (14), endophthalmitis may have resulted from patient contact with soil and subsequent conjunctival inoculation with this species either before or after intraocular surgery. Most patients with R. radiobacter endophthalmitis reported outdoor activities such as gardening or golfing that may have exposed them to soil bacteria (18,19,24). Because R. radiobacter is responsible for hospital-acquired infections (14), nosocomial transmission of the pathogen (especially in the operating room) should be considered.…”

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confidence: 99%

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Three Cases of Post-Cataract Surgery Endophthalmitis Due to Rhizobium (Agrobacterium) radiobacter

et al. 2012

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We present three unrelated post-cataract surgery endophthalmitis cases caused by Rhizobium radiobacter, hospitalized in three different hospitals. Early diagnosis was obtained in two cases by bacterial DNA detection in vitreous samples. All patients recovered from infection, but pars plana vitrectomy was needed in two patients due to rapid clinical deterioration. CASE REPORTSP atient 1. An 81-year-old female patient complained of decreased visual acuity (20/63) 4 weeks after cataract surgery (phacoemulsification) of the right eye (Table 1). Acute postoperative endophthalmitis with severe ocular inflammation was diagnosed. Vitreous (200-l) and aqueous humor (AH; 150-to 200-l) samples were tested by culture using brain heart infusion broth (AES Laboratories, Combourg, France) and eubacterial PCR, as previously described (5). Rhizobium radiobacter was detected by culture in AH and vitreous and by eubacterial PCR in the vitreous. Species identification was confirmed by PCR amplification and sequencing of the 16S rRNA gene (GenBank accession number JQ304788) from the vitreous sample and from isolated colonies, whereas phenotypic identification of the isolated strain remained ambiguous. A 440-bp DNA fragment of the 16S rRNA gene was amplified with primers 91E and 13BS as described by Gauduchon et al. (10). The amplicon was sequenced, and the sequence obtained was compared in a phylogenetic analysis with those available in the BIBI database (http://umr5558-sud-str1 .univ-lyon1.fr/lebibi/lebibi.cgi). Using an agar disk diffusion method (7), the strain was found to be intermediately susceptible to broad-spectrum cephalosporins (especially ceftazidime) but susceptible to cefepime, imipenem, and fluoroquinolones according to the interpretative criteria of the CLSI for Pseudomonas aeruginosa, as previously suggested (14). The patient received two intravitreal injections of vancomycin (1 mg) and ceftazidime (2 mg) on the day of admission and 4 days later, systemic antibiotics for 7 days (intravenous imipenem at 500 mg three times a day and ciprofloxacin at 500 mg orally twice a day), subconjunctival injections of dexamethasone, and topical steroid therapy. One year later, the outcome was favorable.Patient 2. A 75-year-old male patient presented with acute endophthalmitis of moderate severity (Table 1; Fig. 1), 9 days after an uncomplicated phacoemulsification. He was followed up for obstructive sleep apnea and hypertension. Vitreous and AH were sampled, and the patient received an intravitreal injection of vancomycin plus ceftazidime, a systemic antibiotic therapy (intravenous piperacillin at 4 g three times a day and levofloxacin orally at 500 mg once a day, for 7 days), and topical steroid therapy. The following day, visual acuity was reduced to light perception, a 1-mm hypopyon appeared, and a pupillary membrane prevented fundus examination. Pars plana vitrectomy (PPV) was performed on day 3 of hospitalization, and intravitreal injections of antibiotics were repeated the same day and 2 days later. R. radiobacter was detec...

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confidence: 66%

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confidence: 51%

mentioning

confidence: 81%

mentioning

confidence: 99%

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confidence: 99%

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Three Cases of Post-Cataract Surgery Endophthalmitis Due to Rhizobium (Agrobacterium) radiobacter

et al. 2012

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Agrobacterium radiobacter bacteremia in a child with acute lymphoblastic leukemia

et al. 2010

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A. radiobacter is an emerging pathogen affecting immunocompromised children, particularly those with leukemia who carry central venous catheters. Although it has a low virulence, erratic susceptibility patterns, and high frequency of resistance to many antibiotics, ceftriaxone appears to be successful in treatment of most cases. Catheter removal for the clearance of bloodstream infections due to A. radiobacter may not be required in selected patients like the present case.

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Rhizobium radiobacter bacteremia in a neonate

et al. 2011

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Endophthalmitis Caused by Agrobacterium radiobacter

Abstract: Infections due to Agrobacterium radiobacter are rare. This study reports 2 cases of A. radiobacter endophthalmitis. To the authors' knowledge, these are only the second and third reported cases of endophthalmitis caused by this Gram-negative rod.

Cited by 11 publications

References 2 publications

Three Cases of Post-Cataract Surgery Endophthalmitis Due to Rhizobium (Agrobacterium) radiobacter

Three Cases of Post-Cataract Surgery Endophthalmitis Due to Rhizobium (Agrobacterium) radiobacter

Agrobacterium radiobacter bacteremia in a child with acute lymphoblastic leukemia

Rhizobium radiobacter bacteremia in a neonate

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