Etiology, microbiological isolates, and antibiotic susceptibilities in culture-proven pediatric endophthalmitis: a 9-year review

Yang, Yao; Lin, Lei; Li, Yujie; Jiang, Zhaoxin; Li, Cheng; Liu, Manli; Duan, Fang; Lin, Xiaofeng

doi:10.1007/s00417-020-04866-7

Cited by 11 publications

(11 citation statements)

References 38 publications

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“…Moloney et al reported that the sensitivity of gram-negative organisms to ceftazidime was 100%. 2 Recent studies from southern China reported that gram-positive cocci showed a relatively higher susceptibility to cephalosporins (~90%), 9 , 20 while the sensitivity of gram-negative bacteria to cefotadine was 66.67% and cefuroxime was 45.95% in our study. Hence, cephalosporins as first-line agents in the empirical treatment of endophthalmitis need to be vigilant.…”

Section: Discussionsupporting

confidence: 40%

“…At present, topical fluoroquinolones have been used widely as the first-line eye drops for prevention and treatment of infectious eye disease because of their broad spectrum of activity and low toxicity. The sensitivity of levofloxacin to gram-positive bacteria was disclosed to be as high as 82.3%-96.8% 19 , 20 in southern China and 77.5% in Miami. 22 In this study, however, it was only 51.67%, which was much lower than gatifloxacin.…”

Section: Discussionmentioning

confidence: 98%

“… 17–19 The major gram-negative bacterial isolate was Pseudomonas aeruginosa (3.42%), similar to a report from China. 20 However, Pseudomonas aeruginosa accounted for a high proportion of culture-positive isolates in Southern India, ranging from 13.1% to 25.9%, 21 , 22 which may be because Pseudomonas spp. prefer warm and moist environments.…”

Section: Discussionmentioning

confidence: 99%

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Ten-Year Analysis of Pathogenic Factors and Etiological Characteristics of Endophthalmitis from a Tertiary Eye Center in North China

Liu¹,

Wan²,

Zhou³

et al. 2022

IDR

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Purpose To describe the etiology and spectrum of isolated pathogens in endophthalmitis over 10 years from an ophthalmic hospital in North China and report their antimicrobial susceptibilities. Patients and Methods The data covered the patients with endophthalmitis treated at Qingdao Eye Hospital from January 2011 to December 2020. Patients’ medical history, pathogenic factors, bacterial and fungal culture results of intraocular specimens, and in vitro drug sensitivity test results were assessed. Results A total of 524 cases were counted in this study. Exogenous endophthalmitis was the main component, accounting for 94.66%, of which 49.62% of eyes had a history of ophthalmic trauma, intraocular surgery in 26.72% and suppurative keratitis in 17.37%. By comparison, endogenous endophthalmitis was found in only 5.34% of eyes. Among the 292 strains of pathogenic organisms obtained by co-culture, gram-positive bacteria accounted for 64.04%, with Staphylococcus epidermidis as the predominant pathogen (29.45%). Gram-positive cocci were identified in 76.77% of eyes with traumatic endophthalmitis, while 53.70% of keratitis-associated endophthalmitis was caused by fungi. The high susceptibility of bacteria to vancomycin (77.78%~98.33%) supported its continued use as empirical treatment. Among the fluoroquinolones, gram-positive cocci showed a higher susceptibility to gatifloxacin (94.83%), while there was a significant decrease to levofloxacin (51.67%). Gram-negative bacteria were less sensitive to cephalosporins (45.95%~66.67%) than fluoroquinolones (68.42%~78.05%) and aminoglycosides (75.00%~78.05%). Fungal susceptibilities to voriconazole and amphotericin B were 90.16% and 70.31% respectively. More than half of the 11 antibiotics were observed to exhibit a trend of reduced susceptibility. Conclusion Ophthalmic trauma was the primary pathogenic factor of endophthalmitis. Gram-positive cocci were the most common pathogens of traumatic and postoperative endophthalmitis, while suppurative keratitis-associated endophthalmitis often resulted from fungal pathogens. Levofloxacin as the preferred antibiotic in the perioperative period and cephalosporin as the first-line drug for the treatment of empiric endophthalmitis need to be vigilant.

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Section: Discussionsupporting

confidence: 40%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Ten-Year Analysis of Pathogenic Factors and Etiological Characteristics of Endophthalmitis from a Tertiary Eye Center in North China

Liu¹,

Wan²,

Zhou³

et al. 2022

IDR

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“…Among patients with streptococcal endophthalmitis, Streptococcus pneumoniae , viridans group streptococcus and group B β-haemolytic streptococcus were the main isolates, although the dominant isolates varied in different studies [ 8 – 11 ]. Previous studies have focused on paediatric post-traumatic endophthalmitis caused by all pathogens [ 12 – 14 ]. They found that the streptococcus species was a common cause of post-traumatic endophthalmitis in children.…”

Section: Introductionmentioning

confidence: 99%

Post-traumatic endophthalmitis caused by streptococcus species in preschool children: clinical features, antibiotic susceptibilities and outcomes

Yang

Sui

Duan

et al. 2021

Eye

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Background/Objectives Streptococcus is a common cause of post-traumatic endophthalmitis in children. This study aimed to analyse the clinical features, antibiotic susceptibilities and outcomes of traumatic endophthalmitis caused by streptococcus in preschool children. Subjects/Methods Patients aged ≤6 years with traumatic streptococcal endophthalmitis seen at Zhongshan Ophthalmic Center between January 2013 and December 2018 were included in this retrospective study. Results In total, 21 patients (21 eyes) were included. The mean age of the patients was 3.3 ± 1.7 years, where 57.1% were males. Scissors (28.6%, n = 6) were the most common cause of injury; 86.7% of patients were injured at home. Zone I (80.9%) was the most common wound site; 90.5% of patients presented with a traumatic cataract. In general, Streptococcus pneumoniae (47.6%) was the most common isolate. Viridans group streptococci accounted for 58.3% of cases in children aged 0–3 years, while S. pneumoniae accounted for 66.7% of cases in children aged 4–6 years. The susceptibility rates of streptococcus to cefuroxime, levofloxacin and ofloxacin were 100%, 95.0% and 90.5%, respectively. Although all the patients underwent vitrectomy combined with silicone oil tamponade, the final visual outcomes were no better than counting fingers. Conclusions Although S. pneumoniae was the most prevalent organism in general, the dominant species varied between different age groups. The commonly used antibiotics, cefuroxime and fluoroquinolone, showed higher antibiotic susceptibility. Despite prompt treatment, the visual outcomes of paediatric post-traumatic endophthalmitis in preschool children were poor.

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“…The foundation of the treatment for bacterial endophthalmitis is focal and systemic administration of antibiotics; vitrectomy is performed if the endophthalmitis is severe. Unless the patient receives appropriate treatment early in the disease, it causes irreversible damage to the retina, which results in a high probability of vision loss [1][2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Outcomes in 314 Japanese Patients with Bacterial Endophthalmitis: A Multicenter Cohort Study from J-CREST

et al. 2021

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Bacterial endophthalmitis is an intraocular infection that causes rapid vison loss. Pathogens can infect the intraocular space directly (exogenous endophthalmitis (ExE)) or indirectly (endogenous endophthalmitis (EnE)). To identify predictive factors for the visual prognosis of Japanese patients with bacterial endophthalmitis, we retrospectively examined the bacterial endophthalmitis characteristics of 314 Japanese patients and performed statistics using these clinical data. Older patients, with significantly more severe clinical symptoms, were prevalent in the ExE group compared with the EnE group. However, the final best-corrected visual acuity (BCVA) was not significantly different between the ExE and EnE groups. Bacteria isolated from patients were not associated with age, sex, or presence of eye symptoms. Genus Streptococcus, Streptococcus pneumoniae, and Enterococcus were more prevalent in ExE patients than EnE patients and contributed to poor final BCVA. The presence of eye pain, bacterial identification, and poor BCVA at baseline were risk factors for final visual impairment.

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Etiology, microbiological isolates, and antibiotic susceptibilities in culture-proven pediatric endophthalmitis: a 9-year review

Cited by 11 publications

References 38 publications

Ten-Year Analysis of Pathogenic Factors and Etiological Characteristics of Endophthalmitis from a Tertiary Eye Center in North China

Ten-Year Analysis of Pathogenic Factors and Etiological Characteristics of Endophthalmitis from a Tertiary Eye Center in North China

Post-traumatic endophthalmitis caused by streptococcus species in preschool children: clinical features, antibiotic susceptibilities and outcomes

Clinical Characteristics and Outcomes in 314 Japanese Patients with Bacterial Endophthalmitis: A Multicenter Cohort Study from J-CREST

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