Postoperative low-grade endophthalmitis caused by biofilm-producing coccus bacteria attached to posterior surface of intraocular lens

Suzuki, Takashi; Uno, Toshihiko; Kawamura, Y.; Joko, Takeshi; Ohashi, Yuichi

doi:10.1016/j.jcrs.2005.02.032

Cited by 15 publications

(9 citation statements)

References 4 publications

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“…These bacteria can grow in the capsular bag where oxygen pressure is low [9]. Bacteria were reported to be detected on the surface of the IOL optic and in the capsular bag in endophthalmitis after cataract surgery [2, 3]. In our present case, bacteria were observed on the tip of the IOL haptic by SEM.…”

Section: Discussionsupporting

confidence: 51%

“…The precise mechanisms by which these bacteria cause endophthalmitis after cataract surgery remain unknown. Previous reports on low-grade endophthalmitis after cataract surgery showed bacteria on the surface of the removed intraocular lenses (IOLs) by scanning electron microscopy (SEM) [2, 3]. However, these bacteria were detected almost only on the IOL optic, and the presence of bacteria on the IOL haptic has not been examined sufficiently [4].…”

Section: Introductionmentioning

confidence: 99%

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A Case of Delayed-Onset Propionibacterium acnes Endophthalmitis after Cataract Surgery with Implantation of a Preloaded Intraocular Lens

Hayashi

Eguchi

Miyamoto

et al. 2012

Case Rep Ophthalmol

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Purpose: To report a case of delayed-onset endophthalmitis after implantation of a preloaded intraocular lens (IOL) and examine the surgically removed IOL by scanning electron microscopy (SEM). Case: A 77-year-old female underwent uneventful phacoemulsification and aspiration with preloaded silicone IOL implantation. Since intraocular inflammation unexpectedly worsened 1 month after the surgery, she was referred to our hospital. Her visual acuity was hand motion in the left eye. Hypopyon and fibrin formation were observed in the anterior chamber. A diagnosis of postoperative delayed-onset endophthalmitis was made, and vitrectomy with anterior chamber wash-out was performed. As intraocular inflammation remained unchanged postoperatively, an additional surgery with IOL removal was performed. We cultivated the surgically removed samples of aqueous humor and vitreous fluid under both aerobic and anaerobic conditions, performed 16S rDNA clone library analysis of these clinical samples, and examined the removed IOL by SEM. Result: Inflammation subsided after the re-operation. Although cultures of aqueous and vitreous samples were negative, DNA of Propionibacterium acnes was detected in the aqueous humor. The SEM images showed that the rod bacteria and biofilm-like material formed on the tip of the IOL haptic. Conclusion: Delayed-onset endophthalmitis may occur after uneventful implantation of a preloaded IOL. The SEM findings suggested that the tip of the preloaded IOL haptic might scratch bacteria which adhered to the tip of the injector nozzle when the IOL was inserted into the anterior chamber. In some cases with delayed-onset endophthalmitis, IOL removal is needed to eliminate the bacteria which adhere to the tip of the IOL haptic.

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Section: Discussionsupporting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

A Case of Delayed-Onset Propionibacterium acnes Endophthalmitis after Cataract Surgery with Implantation of a Preloaded Intraocular Lens

Hayashi

Eguchi

Miyamoto

et al. 2012

Case Rep Ophthalmol

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“…Furthermore, chimeric Ply187 disrupted the biofilms formed by antibiotic-resistant S. aureus strains. As biofilm formation plays an important role in the pathogenesis of ocular infections, including endophthalmitis (39)(40)(41), the dispersion of biofilms by chimeric Ply187 further indicated its therapeutic potential in the treatment of endophthalmitis.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal Injection of the Chimeric Phage Endolysin Ply187 Protects Mice from Staphylococcus aureus Endophthalmitis

Singh

Donovan

Kumar

2014

Antimicrob Agents Chemother

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cThe treatment of endophthalmitis is becoming very challenging due to the emergence of multidrug-resistant bacteria. Hence, the development of novel therapeutic alternatives for ocular use is essential. Here, we evaluated the therapeutic potential of Ply187AN-KSH3b, a chimeric phage endolysin derived from the Ply187 prophage, in a mouse model of Staphylococcus aureus endophthalmitis. Our data showed that the chimeric Ply187 endolysin exhibited strong antimicrobial activity against both methicillin-sensitive S. aureus and methicillin-resistant S. aureus (MRSA) strains, as evidenced by MIC determinations, reductions in turbidity, and disruption of biofilms. Moreover, exposure of S. aureus to Ply187 for up to 10 generations did not lead to resistance development. The intravitreal injection of chimeric Ply187 (at 6 or 12 h postinfection) significantly improved the outcome of endophthalmitis, preserved retinal structural integrity, and maintained visual function as assessed by electroretinogram analysis. Furthermore, phage lysin treatment significantly reduced the bacterial burden and the levels of inflammatory cytokines and neutrophil infiltration in the eyes. These results indicate that the intravitreal administration of a phage lytic enzyme attenuates the development of bacterial endophthalmitis in mice. To the best of our knowledge, this is the first study demonstrating the therapeutic use of phage-based antimicrobials in ocular infections.

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“…In our case, it is conceivable that there was no, or only subclinical, inflammation for 5 years after the capsulotomy. Biofilm‐producing bacteria attached to IOLs can induce various types of infections including persistent and low‐grade infections 6,7 . However, for biofilm‐producing cocci to have contaminated the IOL during the insertion, and then activated by some unknown factors 5 years after the cataract surgery, seems not very likely.…”

Section: Discussionmentioning

confidence: 99%

Detection of staphylococcus species by polymerase chain reaction in late‐onset endophthalmitis after cataract surgery and posterior capsulotomy

Mochizuki

Murase

Sawada

et al. 2007

Clinical Exper Ophthalmology

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We report a case of late-onset endophthalmitis that developed 5 years after an uneventful phacoemulsification with implantation of a posterior chamber intraocular lens. Posterior capsulotomy was performed with by Nd:YAG laser 1 month after the cataract surgery. Polymerase chain reaction with agarose gel electrophoresis identified a Staphylococcus species in a sample from the aqueous humour. The endophthalmitis was responsive to medical therapy including antibiotic agents, and it resolved without any surgical intervention.

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Postoperative low-grade endophthalmitis caused by biofilm-producing coccus bacteria attached to posterior surface of intraocular lens

Cited by 15 publications

References 4 publications

A Case of Delayed-Onset Propionibacterium acnes Endophthalmitis after Cataract Surgery with Implantation of a Preloaded Intraocular Lens

A Case of Delayed-Onset Propionibacterium acnes Endophthalmitis after Cataract Surgery with Implantation of a Preloaded Intraocular Lens

Intravitreal Injection of the Chimeric Phage Endolysin Ply187 Protects Mice from Staphylococcus aureus Endophthalmitis

Detection of staphylococcus species by polymerase chain reaction in late‐onset endophthalmitis after cataract surgery and posterior capsulotomy

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