Endophthalmitis caused by Klebsiella species

Endogenous endophthalmitis: 10-year experience at a tertiary referral centre

“…Three were culture positive for Klebsiella species, one culture positive for Scedosporium prolificans, and one culture negative. It is welldocumented that certain specific microbes, particularly Klebsiella carry worse prognosis, 12,13 Our study confirms this, with three of four cases (75%) of culture-positive Klebsiella resulting in enucleation, thus leading to the justification of early aggressive management, including early vitrectomy, view permitting, in these cases. Indeed, Yoon et al 10 in their series of Klebsiella-associated EE highlight the importance of a high index of suspicion and early aggressive surgical management in patients with known Klebsiella septicaemia, or those with known hepatic abscess and diabetes mellitus (and thus high risk of Klebsiella), who develop symptoms of EE.…”

“…5,8,10,24 Certainly, final VA is often dependent on the vascular inflammatory response, which may be severe and result in long-term sequelae, even in those successfully managed with tap and injection alone. Klebsiella species identification, or demonstration of a liver abscess, in particular, in association with diabetes mellitus, may necessitate early vitrectomy, as demonstrated in this series and previous studies because of the aggressive nature of this microbe and poor outcomes, 10,12,13 however, it remains unclear whether early vitrectomy would salvage these eyes.…”

“…[8][9][10][11] Historically, the visual outcomes following EE have been poor, particularly when the causative organism is identified as one of the Klebsiella species. 12,13 Few large case series have documented the incidence, clinical features, and outcomes of EE. The purpose of this study is to document the incidence, presentation, visual outcome, and microbiological profile of all cases of EE presenting to a tertiary referral centre.…”

Acute-onset postoperative endophthalmitis caused by multidrug-resistant Klebsiella pneumoniae

“…In reported series, most patients have poor visual outcome despite appropriate antibiotic therapy, and the outcomes are usually phthisis and blindness 5,13. This may be attributed to the highly virulent organism as well as to delayed recognition of antibiotic resistance and susceptibility.…”

“…There have been reports of multidrug-resistant strains of Gram-negative bacteria being isolated from patients with endophthalmitis 4. Endophthalmitis caused by Klebsiella pneumoniae is associated with generally poor visual outcomes, despite treatment with appropriate antibiotics 5. Three cases of acute postoperative endophthalmitis due to multidrug-resistant K. pneumoniae are reported.…”