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

Abstract

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.

Metagenomic Next-Generation Sequencing Detects Pathogens in Endophthalmitis Patients

“…It was consistent with previous reports. 3,8,[31][32][33][34] In our study, the pathogen identified was concordant in seven of 10 culture-positive cases. Discordance between mNGS and culture was also reported in the literature.…”

“…E ndophthalmitis, one of the most severe ophthalmic emergencies, requires urgent treatment to save the vision or salvage the integrity of the eye. 1,2 The common causes of endophthalmitis include trauma, 3,4 intraocular surgery, 5,6 or endogenous dissemination. 7,8 Endophthalmitis may be caused by bacteria 8 or by fungi.…”

Paediatric endophthalmitis: a 10-year retrospective study at Hospital Kuala Lumpur for incidence, risk factors, and outcomes

“…The most commonly identified organisms in our study were coagulase-negative staphylococci and S. aureus, comprising 50% of the isolates, as seen in other studies. 3,8,15 Culture-positive rates have been reported to range from 44% to 75% in Western studies. 11 Narang et al reported 27% culture positivity from ocular specimens in India.…”

Endophthalmitis in children with open eye injury: epidemiology, risk factors, treatment

“…В ретроспективном 5-летнем анализе случаев ТЭ у детей младше 6 лет самым распространенным микроорганизмом при травме был Streptococcus pneumoniae (47,6%), однако у детей в возрасте 0-3 лет чаще (58,3%) выявлялись стрептококки группы Viridans, а у детей в возрасте 4-6 лет -S. pneumoniae (66,7%). Чувствительность стрептококка к цефуроксиму, левофлоксацину и офлоксацину составляла 100, 95,0 и 90,5% соответственно [15]. ТЭ, обусловленный Enterococcus faecalis, встречается редко и при своевременном оказании медицинской помощи протекает благоприятно [16].…”