The microbiology of endophthalmitis: global trends and a local perspective

Abstract

Endophthalmitis is a rare but frequently devastating infection, caused by diverse organisms, including bacteria, viruses, fungi, and parasites. The causative agents of endophthalmitis vary according to the mechanism. The involvement of intraocular structures can result from exogenous spread from ocular trauma, infection of adjacent structures, or as a complication of intraocular surgery. Of the causes of exogenous endophthalmitis, post-operative endophthalmitis is the most frequently encountered; specifically, cataract surgery is the most frequent eye surgery and, thus, leads the list of surgery-associated endophthalmitis. Exogenous source is far more common than endogenous endophthalmitis, a disease that is caused by the hematogenous spread of organisms from a remote infectious site to the eye, leading to severe visual loss. Several large series estimate that endogenous endophthalmitis accounts for 2-15 % of all cases of endophthalmitis. Progressive vitritis is a hallmark for all forms of endophthalmitis, accompanied by intraocular inflammation, loss of vision, pain, and hypopyon. The common presentation consists of reduced vision, conjunctival injection, pain, and eyelid swelling. We reviewed the microbiology of endophthalmitis during a 9-year period in Winnipeg, Canada. Gram-positive bacteria with coagulase-negative staphylococci are the most common causative organisms, reflecting the association with surgical procedures.

Identification of Polybacterial Communities in Patients with Postoperative, Posttraumatic, and Endogenous Endophthalmitis through 16S rRNA Gene Libraries

“…Exogenous endophthalmitis infection results from an exterior breach of the globe caused either through surgery (postoperative), trauma (posttraumatic), or by fulminant progression of keratitis or scleritis. Since millions of cataract surgeries are performed worldwide (3), postoperative endophthalmitis (POE) is the most frequently encountered exogenous infection (4). On the contrary, endogenous endophthalmitis (EE), which is less common (4), results from the metastasis of bacteria into the eye from a distant infection site.…”

“…Since millions of cataract surgeries are performed worldwide (3), postoperative endophthalmitis (POE) is the most frequently encountered exogenous infection (4). On the contrary, endogenous endophthalmitis (EE), which is less common (4), results from the metastasis of bacteria into the eye from a distant infection site. Thus, endophthalmitis needs timely therapy to control the infection and to minimize ocular morbidity.…”

The Incidence of Postoperative Endophthalmitis Before and After a Revised Preoperative Surgical Site Preparation Protocol

“…The organism profile was comparable to other published reports. 1, [6][7][8][9] As postoperative endophthalmitis is a devastating complication of cataract extraction operations, numerous studies have been carried out to examine the factors that could reduce its incidence. In the European Society of Cataract and Refractive Surgeons (ESCRS) endophthalmitis study, 10 the authors concluded that the use of intracameral cefuroxime at the end of surgery would significantly reduce the occurrence of postoperative endophthalmitis.…”

Application of lipid nanoparticles to ocular drug delivery

“…Exogenous endophthalmitis is most frequently post-operative (keratoplasty); endogenous endophthalmitis, caused by the hematogenous spread of organisms from a remote infectious site into the eye, accounts for 2-15 % of all cases. The most important component of treatment is the intravitreal injection of antibiotics, along with vitrectomy in severe cases[49].…”