4.2 Article

Ocular culture-proven endogenous endophthalmitis: a 5-year retrospective study of the microorganism spectrum at a tertiary referral center in Turkey

Journal

INTERNATIONAL OPHTHALMOLOGY
Volume 39, Issue 8, Pages 1743-1751

Publisher

SPRINGER
DOI: 10.1007/s10792-018-0997-9

Keywords

Bacterial endophthalmitis; Candida; Endogenous endophthalmitis; Fungal endophthalmitis; Treatment

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Purpose The aim of this study was to review the clinical profile of endogenous endophthalmitis (EE), including predisposing systemic conditions, responsible microorganisms, clinical presentations, and outcomes. Methods We reviewed data from 21 eyes of 15 patients diagnosed with EE and compared their clinical characteristics over a 5-year period. All patients were ocular fluid cultures proven. Generalized estimating equations (GEE) were used to analyze the effects of vitrectomy, diabetes, malignity, and clinical presentation condition on VA. Results Diabetes was the most common illness of EE patients (40.0%). In this geographical region, Pseudomonas aeruginosa (4.8%), Methicillin-sensitive Staphylococcus aureus (4.8%), Methicillin-resistant Staphylococcus aureus (4.8%), and Mycobacterium tuberculosis (4.8%) were identified as causative bacterial microorganisms (n = 5) in patients with EE, and Candida Species (71.4%) and Aspergillus (4.8%) were identified as causative fungal microorganisms (n = 16) in patients with EE in the vitreous specimens. Fungemia (76.2%) (especially yeasts) was the most common extraocular infection source among patients with EE. Fourteen eyes (66.7%) were managed with intravitreal injections of antimicrobial medicines, and seven eyes (33.3%) also underwent vitrectomy. GEE models revealed that logMAR final VA values were found as lower than initial VA assessments. Conclusion Depending on the different regions of the world, the characteristics of disease have been declared invariable. This study provides information about the clinical and microbiological profile of ocular culture-proven EE patients in a region of straddling the Asia and European continents. Aggressive medical and surgical treatment may result in favorable outcomes.

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