Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Sadiq MA, Hassan M, Agarwal A et al (2015) Endogenous endophthalmitis: diagnosis, management, and prognosis. J Ophthalmic Inflamm Infect 5:32. https://doi.org/10.1186/s12348-015-0063-y

    Article  PubMed  PubMed Central  Google Scholar 

  2. Jackson TL, Paraskevopoulos T, Georgalas I (2014) Systematic review of 342 cases of endogenous bacterial endophthalmitis. Surv Ophthalmol 59:627–635. https://doi.org/10.1016/j.survophthal.2014.06.002

    Article  PubMed  Google Scholar 

  3. Okada AA, Johnson RP, Liles WC et al (1994) Endogenous bacterial endophthalmitis. Report of a 10-year retrospective study. Ophthalmology 101:832–838

    Article  CAS  PubMed  Google Scholar 

  4. Shrader SK, Band JD, Lauter CB et al (1990) The clinical spectrum of endophthalmitis: incidence, predisposing factors, and features influencing outcome. J Infect Dis 162:115

    Article  CAS  PubMed  Google Scholar 

  5. Relhan N, Forster RK, Flynn HW Jr (2018) Endophthalmitis: then and now. Am J Ophthalmol 187:xx–xxvii. https://doi.org/10.1016/j.ajo.2017.11.021

    Article  PubMed  Google Scholar 

  6. Jackson TL, Eykyn SJ, Graham EM et al (2003) Endogenous bacterial endophthalmitis: a 17-year prospective series and review of 267 reported cases. Surv Ophthalmol 48:403–423

    Article  PubMed  Google Scholar 

  7. Schiedler V, Scott IU, Flynn HW Jr et al (2004) Culture-proven endogenous endophthalmitis: clinical features and visual acuity outcomes. Am J Ophthalmol 137:725–731. https://doi.org/10.1016/j.ajo.2003.11.013

    Article  PubMed  Google Scholar 

  8. Lingappan A, Wykoff CC, Albini TA et al (2012) Endogenous fungal endophthalmitis: causative organisms, management strategies, and visual acuity outcomes. Am J Ophthalmol 153(162–166):e1. https://doi.org/10.1016/j.ajo.2011.06.020

    Article  Google Scholar 

  9. Binder MI, Chua J, Kaiser PK et al (2003) Endogenous endophthalmitis: an 18-year review of culture-positive cases at a tertiary care center. Medicine (Baltimore) 82:97–105

    Article  Google Scholar 

  10. Sharma S, Padhi TR, Basu S et al (2014) Endophthalmitis patients seen in a tertiary eye care centre in Odisha: a clinico-microbiological analysis. Indian J Med Res 139:91–98

    PubMed  PubMed Central  Google Scholar 

  11. Lim HW, Shin JW, Cho HY et al (2014) Endogenous endophthalmitis in the Korean population: a 6-year retrospective study. Retina 34:592–602. https://doi.org/10.1097/IAE.0b013e3182a2e705

    Article  PubMed  Google Scholar 

  12. Connell PP, O’Neill EC, Fabinyi D et al (2011) Endogenous endophthalmitis: 10-year experience at a tertiary referral centre. Eye (Lond) 25:66–72. https://doi.org/10.1038/eye.2010.145

    Article  CAS  Google Scholar 

  13. Gupta A, Orlans HO, Hornby SJ et al (2014) Microbiology and visual outcomes of culture-positive bacterial endophthalmitis in Oxford, UK. Graefes Arch Clin Exp Ophthalmol 252:1825–1830. https://doi.org/10.1007/s00417-014-2658-7

    Article  CAS  PubMed  Google Scholar 

  14. Vaziri K, Pershing S, Albini TA et al (2015) Risk factors predictive of endogenous endophthalmitis among hospitalized patients with hematogenous infections in the United States. Am J Ophthalmol 159:498–504. https://doi.org/10.1016/j.ajo.2014.11.032

    Article  PubMed  Google Scholar 

  15. Sridhar J, Flynn HW Jr, Kuriyan AE et al (2013) Endogenous fungal endophthalmitis: risk factors, clinical features, and treatment outcomes in mold and yeast infections. J Ophthalmic Inflamm Infect 3:60. https://doi.org/10.1186/1869-5760-3-60

    Article  PubMed  PubMed Central  Google Scholar 

  16. Connell PP, O’Neill EC, Amirul Islam FM et al (2010) Endogenous endophthalmitis associated with intravenous drug abuse: 7-year experience at a tertiary referral center. Retina 30:1721–1725. https://doi.org/10.1097/iae.0b013e3181dd6db6

    Article  PubMed  Google Scholar 

  17. Chen YJ, Kuo HK, Wu PC et al (2004) A 10-year comparison of endogenous endophthalmitis outcomes: an east Asian experience with Klebsiella pneumoniae infection. Retina 24:383–390

    Article  PubMed  Google Scholar 

  18. Sheu SJ (2017) Endophthalmitis. Korean J Ophthalmol 31:283–289. https://doi.org/10.3341/kjo.2017.0036

    Article  PubMed  PubMed Central  Google Scholar 

  19. Cho H, Shin YU, Siegel NH et al (2016) Endogenous endophthalmitis in the American and Korean population: an 8-year retrospective study. Ocul Immunol Inflamm 26:1–8. https://doi.org/10.1080/09273948.2016.1195000

    Article  Google Scholar 

  20. Wong JS, Chan TK, Lee HM et al (2000) Endogenous bacterial endophthalmitis: an East Asian experience and a reappraisal of a severe ocular affliction. Ophthalmology 107:1483–1491

    Article  CAS  PubMed  Google Scholar 

  21. Ratra D, Saurabh K, Das D et al (2015) Endogenous endophthalmitis: a 10-year retrospective study at a tertiary hospital in South India. Asia Pac J Ophthalmol 4:286–292. https://doi.org/10.1097/APO.0000000000000120

    Article  Google Scholar 

  22. Paulus YM, Cheng S, Karth PA et al (2016) Prospective trial of endogenous fungal endophthalmitis and chorioretinitis rates, clinical course, and outcomes in patients with fungemia. Retina 36:1357–1363. https://doi.org/10.1097/iae.0000000000000919

    Article  PubMed  Google Scholar 

  23. Durand ML (2013) Endophthalmitis. Clin Microbiol Infect 19:227–234. https://doi.org/10.1111/1469-0691.12118

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Riddell JT, Comer GM, Kauffman CA (2011) Treatment of endogenous fungal endophthalmitis: focus on new antifungal agents. Clin Infect Dis 52:648–653. https://doi.org/10.1093/cid/ciq204

    Article  CAS  PubMed  Google Scholar 

  25. Urtti A (2006) Challenges and obstacles of ocular pharmacokinetics and drug delivery. Adv Drug Deliv Rev 58:1131–1135. https://doi.org/10.1016/j.addr.2006.07.027

    Article  CAS  PubMed  Google Scholar 

  26. Essman TF, Flynn HW Jr, Smiddy WE et al (1997) Treatment outcomes in a 10-year study of endogenous fungal endophthalmitis. Ophthalmic Surg Lasers 28:185–194

    CAS  PubMed  Google Scholar 

  27. Birnbaum FA, Gupta G (2016) The role of early vitrectomy in the treatment of fungal endogenous endophthalmitis. Retin Cases Brief Rep 10:232–235. https://doi.org/10.1097/ICB.0000000000000238

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Marmara University School of Medicine, Fevzi Çakmak Mah. Muhsin Yazıcıoğlu Cad. No:10, Pendik/Istanbul, Turkey

    Hande Celiker & Haluk Kazokoglu

Authors
  1. Hande Celiker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Haluk Kazokoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hande Celiker.

Ethics declarations

Conflict of interest

None of the authors has conflict of interest with the submission. The authors alone are responsible for the content and writing of the paper

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Celiker, H., Kazokoglu, H. Ocular culture-proven endogenous endophthalmitis: a 5-year retrospective study of the microorganism spectrum at a tertiary referral center in Turkey. Int Ophthalmol 39, 1743–1751 (2019). https://doi.org/10.1007/s10792-018-0997-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-018-0997-9

Keywords

Search

Navigation