Role of External Bacterial Flora in the Pathogenesis of Acute Postoperative Endophthalmitis

Speaker, Mark G.; Milch, Florence A.; Shah, Mahendra; Eisner, William; Kreiswirth, Barry N.

doi:10.1016/s0161-6420(91)32239-5

Cited by 576 publications

(337 citation statements)

References 28 publications

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“…Diabetes mellitus and old age have also been associated with immunosuppression and an increased susceptibility to infection. [20][21][22] This susceptibility may increase the risk of endophthalmitis in diabetic and elderly patients following an intravitreal injection. Numerous studies indicate that the most common source of bacteria appears to be from the patients' own flora.…”

Section: Resultsmentioning

confidence: 99%

“…Numerous studies indicate that the most common source of bacteria appears to be from the patients' own flora. [18][19][20][21] Blepharitis is a reported risk factor for endophthalmitis, [19][20][21][22] and the risk may be increased during an office-based procedure where the sterile technique may not be as rigorous as in the operating room setting. Despite disinfection of the lids and conjunctival surface with povidone-iodine, the lashes may serve as a nidus of infection if they abut the needle before its entry into the eye.…”

Section: Resultsmentioning

confidence: 99%

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Incidence and management of acute endophthalmitis after intravitreal bevacizumab (Avastin) injection

Artunay

Yüzbaşıoğlu

Rasier

et al. 2009

Eye

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Introduction The aim of this study was to report the incidence and management of acute endophthalmitis after intravitreal injection of Avastin (bevacizumab), and visual acuity outcomes of three eyes of three patients who developed acute endophthalmitis following intravitreal injection of Avastin. Methods This clinical retrospective, non-comparative study included 3022 intravitreal injections of 1.25 mg bevacizumab consecutively performed for 1822 eyes with exudative age-related macular degeneration and other retinal diseases. Of 3022 injections, 1200 were reinjections. After clinical appearance of post-injection endophthalmitis, immediate intervention was performed, including injection of intravitreal antibiotics and early pars plana vitrectomy. Results Three eyes of three patients with acute postoperative endophthalmitis were identified in the first week following intravitreal injections of 1.25 mg bevacizumab. Among of these patients, two cases were culture-positive and one case was culture-negative. Compared with presenting visual acuities, all of three patients improved at the end of follow-up time. The overall incidence rate of post-injection culture-proven endophthalmitis was 0.066%. Discussion Acute culture-proven endophthalmitis is still a potential complication of intravitreal bevacizumab injection (approximately 0.066%) despite using maximal sterile techniques. Acute post-injection endophthalmitis following intravitreal bevacizumab occurs rapidly and can result in severe loss of vision. Prompt

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Incidence and management of acute endophthalmitis after intravitreal bevacizumab (Avastin) injection

Artunay

Yüzbaşıoğlu

Rasier

et al. 2009

Eye

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“…It is a commensal organism that can readily gain access into the eye, given the opportunity [121,174,185]. Individuals whose eyes are compromised due to various reasons including ocular surgery or trauma, contact lens use, viral infection or other eye illnesses are at high risk of developing this infection [26,32,135].…”

Section: Bacterial Keratitismentioning

confidence: 99%

Pathogenesis of microbial keratitis

Lakhundi

Siddiqui

Khan

2017

Microbial Pathogenesis

171

121

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Microbial keratitis is a sight-threatening ocular infection caused by bacteria, fungi, and protist pathogens. Epithelial defects and injuries are key predisposing factors making the eye susceptible to corneal pathogens. Among bacterial pathogens, the most common agents responsible for keratitis include Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumonia and Serratia species. Fungal agents of corneal infections include both filamentous as well as yeast, including Fusarium, Aspergillus, Phaeohyphomycetes, Curvularia, Paecilomyces, Scedosporium and Candida species, while in protists, Acanthamoeba spp. are responsible for causing ocular disease. Clinical features include redness, pain, tearing, blur vision and inflammation but symptoms vary depending on the causative agent. The underlying molecular mechanisms associated with microbial pathogenesis include virulence factors as well as the host factors that aid in the progression of keratitis, resulting in damage to the ocular tissue. The treatment therefore should focus not only on the elimination of the culprit but also on the neutralization of virulence factors to minimize the damage, in addition to repairing the damaged tissue. A complete understanding of the pathogenesis of microbial keratitis will lead to the rational development of therapeutic interventions. This is a timely review of our current understanding of the advances made in this field in a comprehensible manner. Coupled with the recently available genome sequence information and high throughput genomics technology, and the availability of innovative approaches, this will stimulate interest in this field.

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“…1 Also in the same period, in Scotland, 2 a hospital infection control team reported more acute PE than expected after cataract surgery, according to the normal incidence. 3 Among the many risk factors involved in the PE pathogenesis, [4][5][6][7][8][9][10][11] it is difficult to assess the weight of climatic influence; however, as conjunctival bacteria are the main source of contamination in cataract surgery, 12,13 it is quite logical to expect that the prevalence of conjunctival bacteria determines the prevalence of the infectious PE. Today, the world-wide use of povidona iodine solution as a preoperative prophylaxis in cataract extraction 14 could provide homogeneity in the kind of bacteria that produce PE all over the world, which was impossible to detect when a great number of different prophylactic techniques were used.…”

Section: Introductionmentioning

confidence: 99%

Climatic influence on conjunctival bacteria of patients undergoing cataract surgery

Rubio

2004

Eye

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Role of External Bacterial Flora in the Pathogenesis of Acute Postoperative Endophthalmitis

Cited by 576 publications

References 28 publications

Incidence and management of acute endophthalmitis after intravitreal bevacizumab (Avastin) injection

Incidence and management of acute endophthalmitis after intravitreal bevacizumab (Avastin) injection

Pathogenesis of microbial keratitis

Climatic influence on conjunctival bacteria of patients undergoing cataract surgery

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