Pseudomonas aeruginosa endophthalmitis caused by contamination of the internal fluid pathways of a phacoemulsifier

Zaluski, S; Clayman, Henry M.; G, Karsenti; Bourzeix, Sylvie; Tournemire, Alain; Faliu, Bruno; Gulian, C.; Grimont, Francine

doi:10.1016/s0886-3350(99)80052-2

Cited by 44 publications

(30 citation statements)

References 14 publications

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“…Pseudomonas aeruginosa is one of the most common Gramne gative pathogens associated with nosocomial infections (14) . The epidemics seem to be related to contaminated intraocular irrigating solutions (6,7,9,12,14) . Pseudomonas was also identified in povidone-iodine solution (14) , at the fluid pathways of a phacoemulsifier (9) , water of autoclave (12) and air-conditioning system (14) .…”

Section: Discussionmentioning

confidence: 99%

“…The epidemics seem to be related to contaminated intraocular irrigating solutions (6,7,9,12,14) . Pseudomonas was also identified in povidone-iodine solution (14) , at the fluid pathways of a phacoemulsifier (9) , water of autoclave (12) and air-conditioning system (14) . Technics as high-resolution fluorescent amplified fragment length polymorphism ana lysis can identify the source of the outbreak to help preventing new ones (16) .…”

Section: Discussionmentioning

confidence: 99%

“…Outbreaks of postoperative P. aeruginosa endophthalmitis have been described in the literature (6)(7)(8)(9)(10)(11)(12)(13)(14) . The association with intrinsic contamination of ophthalmic solutions and contaminated instruments or equipment has been reported (6)(7)(8)(9)(10)(11)(12)(13) . The purpose of this study is describing an outbreak of Pseudomo nas aeruginosa endophthalmitis after cataract surgery, which occurred at one ophthalmological center of Eunapólis city, Bahia, Brazil.…”

Section: Introductionmentioning

confidence: 99%

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An outbreak of forty five cases of Pseudomonas aeruginosa acute endophthalmitis after phacoemulsification

Guerra¹,

Freitas²,

Parcero³

et al. 2012

Arq. Bras. Oftalmol.

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Purpose: To describe an outbreak of Pseudomonas aeruginosa endophthalmitis post cataract surgery. Clinical findings, treatment and outcome are discussed. Methods: Clinical charts review of forty-five patients treated for endophthalmi tis in a two-day period. The patients underwent primary vitrectomy, anterior chamber irrigation and intravitreous antibiotic injection. Cultures from vitreous and anterior chamber samples were performed in all patients. Results: Forty-five patients (twenty-three men and twenty-two women) were identified. The average age was 71.2 years (range, 56-83 years). The right eye (62%) was affected more often than the left eye (38%). The median interval between surgery and endophthalmitis onset was 5.5 days (range, 5-6 days). The visual acuity at the diagnosis was better than 20/40 in one patient (2%), from 20/40 to 20/200 in one patient (2%), from 20/400 to counting fingers in two patients (4%), hand movements in eleven patients (24%), and light perception in thirty patients (68%). Pseudomo nas aeruginosa was the isolated agent in twenty-six vitreous samples and in three anterior chamber samples. Overall, one patient (2%) achieved a final visual acuity better than 20/40; eight patients (18%) achieved a final visual acuity from 20/40 to 20/200; six patients (13%) achieved a final visual acuity from 20/400 to counting fingers; eleven patients (25%) achieved a final acuity of hand movements; thirteen patients (29%) achieved a final acuity of light perception and six (13%) patients had no light perception at the last examination. None of these eyes underwent evisceration or enucleation in a three-month follow-up period. Conclusion:Even with all the safety that cataract surgery has achieved, today, en dophthalmitis remains a risk and a fearful complication of this procedure. In the present study, it was impossible to identify the source of the outbreak.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An outbreak of forty five cases of Pseudomonas aeruginosa acute endophthalmitis after phacoemulsification

Guerra¹,

Freitas²,

Parcero³

et al. 2012

Arq. Bras. Oftalmol.

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“…9,11 Other outbreaks have been presumed to be because of defective sterilisation and/or poor operative room hygiene, 12,13 and in these cases a variety of causative organisms can be found in one outbreak. In others, the same organism is implicated in all or most cases and intraoperative contamination can be identified, for example, internal contamination of the phacoemulsification machine 14,15 or the vitrectomy apparatus; 16,17 contamination of the ultrasonic cleaning bath and detergent, 18 viscoelastic, 19 Figure 7 Diatoms.…”

Section: Discussionmentioning

confidence: 99%

“…10 Although cases of endophthalmitis are usually isolated, clustered outbreaks have been described and exogenous sources have sometimes been identified. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] In a 14-week period, at the end of 1999, there were eight cases of postphacoemulsification endophthalmitis in the Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow. The Tennent Institute is the tertiary referral unit for Glasgow and the West of Scotland.…”

Section: Introductionmentioning

confidence: 99%

Residual debris as a potential cause of postphaco- emulsification endophthalmitis

Leslie

Aitken

Barrie

et al. 2003

Eye

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Aim To examine residual debris within sterilised instruments prior to cataract surgery. Methods (i) Flushings from 32 sets of phacoemulsification instruments, sterilised according to hospital routine protocols, were taken preoperatively and analysed by scanning electron microscopy (SEM).(ii) A total of 16 sets of flushings from a different institute were collectedFwith separation of samples collected from phacoemulsification and those from irrigation-aspiration (IA) instrumentsFand analysed in the same way.(iii) A total of 15 sets of flushings were collected from instruments where an automated flushing system was used prior to sterilisation. Results(i) In the first study, 62% were clean, 16% were moderately contaminated and 22% were severely contaminated. Various contaminants were identified including lens capsule and cells, man-made fibres, squamous cells, bacteria, fungal elements, diatoms, red blood cells and proteinaceous material.(ii) In the second study, the results were similar and contamination of both phacoemulsification and IA instruments was shown.(iii) The third study showed that although a decrease in contamination followed automated flushing, contamination was not completely eliminated. Conclusions Although all equipment had been sterilised, pyrogenic material was still present. These findings emphasise the importance of meticulous cleaning of all surgical equipment in which biological debris can remain.

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Endophthalmitis Caused by Gram-Negative Bacteria

Relhan

Flynn

2017

Endophthalmitis

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Pseudomonas aeruginosa endophthalmitis caused by contamination of the internal fluid pathways of a phacoemulsifier

Abstract: The profession should be cognizant of this cause of endophthalmitis, although its occurrence is rare. Cataract surgeons should test samples from the collection bags of their phacoemulsifiers to ensure there is no bacteriological contamination.

Cited by 44 publications

References 14 publications

An outbreak of forty five cases of Pseudomonas aeruginosa acute endophthalmitis after phacoemulsification

An outbreak of forty five cases of Pseudomonas aeruginosa acute endophthalmitis after phacoemulsification

Residual debris as a potential cause of postphaco- emulsification endophthalmitis

Endophthalmitis Caused by Gram-Negative Bacteria

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