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Lai KKH, Wang S, Kuk AKT, Tsang A, Tai JHC, Ko CKL. Acinetobacter baumannii- calcoaceticus Complex-associated Orbital Cellulitis: A Case Report and Literature Review. Ocul Immunol Inflamm 2023; 31:1537-1540. [PMID: 36074653 DOI: 10.1080/09273948.2022.2103715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 06/10/2022] [Accepted: 07/14/2022] [Indexed: 10/14/2022]
Abstract
Acinetobacter baumannii-calcoaceticus complex is emerging as one of the most common causes of hospital-acquired infection globally. We present a case of orbital cellulitis caused by the A. baumannii-calcoaceticus complex. A 73-year-old Chinese woman with a history of rheumatoid arthritis presented with subacute onset of right upper eyelid swelling for 1 week. Computer tomography revealed a post-septal soft tissue lesion located at the right superior orbit that was enhanced with contrast, compressing on the superior aspect of the globe. Anterior orbitotomy with incisional biopsy of the right superior orbital lesion was performed, and histopathological examination was consistent with nonspecific inflammatory mass. The microbiological culture of the specimen yielded A. calcoaceticus and A. baumannii complex, which was sensitive to ciprofloxacin, ampicillin, and gentamicin. The infection resolved after a 1-week course of intravenous augmentin. Ophthalmologists should be alert to the possibility of patients having A. baumannii and A. calcoaceticus in periorbital cellulitis.
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Affiliation(s)
- Kenneth K H Lai
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, China
| | - Sarah Wang
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, China
| | - Andrew K T Kuk
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, China
| | - Alan Tsang
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, China
| | - Jacqueline H C Tai
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, China
| | - Callie K L Ko
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, China
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Panigrahi PK, Thareja J, Mohanty L, Minj A. Pseudo endophthalmitis following intravitreal triamcinolone acetonide for cystoid macular edema in a post-vitrectomised eye. Photodiagnosis Photodyn Ther 2023; 42:103548. [PMID: 37011718 DOI: 10.1016/j.pdpdt.2023.103548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/31/2023] [Indexed: 04/03/2023]
Abstract
Post-operative endophthalmitis is a vision threatening complication following intraocular surgery requiring prompt treatment. Clinical picture mimicking infectious endophthalmitis can rarely be produced following intravitreal triamcinolone acetonide injection. A 65-year-old male with previous history of pars plana vitrectomy and lens removal was diagnosed with post-operative cystoid macular edema in his right eye. He received intravitreal triamcinolone acetonide injection in his right eye. Two days following the injection he complained of further reduction in vision and presented with a clinical picture resembling infectious endophthalmitis. Nil active intervention was done. There was significant improvement in vision one week following the injection. Ophthalmologists should be aware of this clinical scenario so that excessive and unwarranted treatment can be avoided.
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Affiliation(s)
- Pradeep Kumar Panigrahi
- Department of Ophthalmology, Institute of Medical Sciences and SUM Hospital, Siksha O Anusandhan (deemed to be) University, 8-Kalinga Nagar, Bhubaneswar 751003, Odisha.
| | - Japesh Thareja
- Department of Ophthalmology, Institute of Medical Sciences and SUM Hospital, Siksha O Anusandhan (deemed to be) University, 8-Kalinga Nagar, Bhubaneswar 751003, Odisha
| | - Loknath Mohanty
- Department of Ophthalmology, Institute of Medical Sciences and SUM Hospital, Siksha O Anusandhan (deemed to be) University, 8-Kalinga Nagar, Bhubaneswar 751003, Odisha
| | - Anita Minj
- Department of Ophthalmology, Institute of Medical Sciences and SUM Hospital, Siksha O Anusandhan (deemed to be) University, 8-Kalinga Nagar, Bhubaneswar 751003, Odisha
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Udomwech L, Karnjana K, Jewboonchu J, Rattanathamma P, Narkkul U, Juhong J, Mordmuang A. Bacterial microbiota of the contact lens surface and associated care behaviours. Heliyon 2022; 8:e09038. [PMID: 35265768 PMCID: PMC8898908 DOI: 10.1016/j.heliyon.2022.e09038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/06/2022] [Accepted: 02/25/2022] [Indexed: 12/17/2022] Open
Abstract
Introduction Contact lens (CL) wear has been reported to cause changes to the microbiome of the ocular surface. More insight into the alteration of this microenvironment can help to understand the pathogenesis of CL-related eye infections. Knowledge of the relationship between the CL wearer's behaviours and pathogens would help health care providers focus on each step of proper CL care. This study aims to determine the behaviours that might be associated with the community of bacteria on CL. Methods A cross-sectional design was performed using anonymous questionnaires to obtain demographic data and assess hygiene practices among volunteering wearers. The CLs used were collected to evaluate the prevalence of pathogenic bacteria associated with ocular infections by PCR and microbiota analysis. Results The bacterial microbiota study revealed a total of 19 genera and 26 isolated strains from 20 eligible CLs. Enterobacter, Staphylococcus, and Achromobacter were the main genus in this subject population. Staphylococcus pasteuri and Achromobacter agilis were the most common pathogens at 65% and 35%, respectively. Enterobacter mori, a nonpathogenic organism, was found to be the most predominant strain, accounting for 27.51% of the total bacterial constituents. The risk behaviour of CL wear that was significantly associated with A. agilis contamination was cleaning the CL case with tap water (P value = 0.04). Conclusions This is the first study focusing on the association between the culture selected microbial community on the CL surface and compehensive behavioural characteristics. Environmental contamination was the main source of microbes found on CL surfaces. An emphasis in patient education should be placed on careful handling during the CL care routine and managing the hygiene of the surroundings.
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Chen KJ, Sun MH, Hou CH, Chen HC, Chen YP, Wang NK, Liu L, Wu WC, Chou HD, Kang EY, Lai CC. Susceptibility of bacterial endophthalmitis isolates to vancomycin, ceftazidime, and amikacin. Sci Rep 2021; 11:15878. [PMID: 34354181 DOI: 10.1038/s41598-021-95458-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/27/2021] [Indexed: 11/08/2022] Open
Abstract
Bacterial endophthalmitis is a rare intraocular infection, and prompt administration of intravitreal antibiotics is crucial for preventing severe vision loss. The retrospective study is to investigate the in vitro susceptibility to the antibiotics vancomycin, amikacin, and ceftazidime of bacterial endophthalmitis isolates in specimens at a tertiary referral center from January 1996 to April 2019 in Taiwan. Overall, 450 (49.9%) isolates were Gram positive, 447 (49.6%) were Gram negative, and 4 (0.4%) were Gram variable. In Gram-positive isolates, coagulase-negative staphylococci were the most commonly cultured bacteria (158, 35.1%), followed by Streptococci (100, 22.2%), Enterococci (75, 16.7%), and Staphylococcus aureus (70, 15.6%). In Gram-negative isolates, they were Klebsiella pneumoniae (166, 37.1%) and Pseudomonas aeruginosa (131, 29.3%). All Gram-positive organisms were susceptible to vancomycin, with the exception of one Enterococcus faecium isolate (1/450, 0.2%). Of the Gram-negative isolates, 96.9% and 93.7% were susceptible to ceftazidime and amikacin, respectively. Nine isolates (9/447, 2.0%) were multidrug-resistant Gram-negative bacteria, comprising K. pneumoniae (4/164, 2.4%), Acinetobacter baumannii (2/3, 67%), and Stenotrophomonas maltophilia (3/18, 17%). In conclusion, in vitro susceptibility testing revealed that vancomycin remains the suitable antibiotic treatment for Gram-positive endophthalmitis. Ceftazidime and amikacin provide approximately the same degree of Gram-negative coverage. Multidrug-resistant bacterial endophthalmitis was uncommon.
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Ozkan J, Coroneo M, Sandbach J, Subedi D, Willcox M, Thomas T. Bacterial contamination of intravitreal needles by the ocular surface microbiome. Ocul Surf 2020; 19:169-175. [PMID: 32497656 DOI: 10.1016/j.jtos.2020.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/15/2020] [Accepted: 05/15/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE The ocular surface microbiota are recognised as one of causative microorganisms in post-procedural endophthalmitis but in many cases the vitreous tap is culture negative. This study investigated bacterial contamination of intravitreal (IVT) needles using multiple approaches covering culturing, 16S rRNA gene sequencing, fluorescent in situ hybridisation (FISH) and scanning electron microscopy (SEM). METHODS IVT needles were obtained immediately after injection from patients undergoing treatment for predominantly age-related macular degeneration. Eighteen needles were analysed by culturing on chocolate blood agar. In addition, 40 needles were analysed by extracting DNA and paired-end sequencing of the 16S rRNA gene. Sequences were quality filtered (USEARCH), taxonomically classified (SILVA) and contaminant filtered (DECONTAM). Nine needles were analysed by either FISH using the bacterial probe EUB338 or SEM. RESULTS Using culturing, three bacteria were identified from 5 of 18 needles (28%) - Kocuria kristinae, Staphylococcus hominis and Sphingomonas paucimobilis. The negative control needles showed no growth. Following rigorous data filtering, bacterial community analysis using 16S rRNA gene sequencing showed the presence of predominantly Corynebacterium but also Pseudomonas, Acinetobacter, Sphingomonas, Staphylococcus and Bacillus on the needles. Cocci-shaped cells in a tetrad formation were observed using FISH, while SEM images showed cocci-shaped bacteria in pairs and irregular tetrads. CONCLUSIONS The study showed evidence for a large diversity of bacteria on IVT needles and visually confirmed their adherence. The diversity was similar to that found on the ocular surface and in conjunctival tissue. This suggests the risk of exogenous endophthalmitis remains even with sterilization of the conjunctival surface.
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Affiliation(s)
- Jerome Ozkan
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, Australia.
| | - Minas Coroneo
- Department of Ophthalmology, Prince of Wales Hospital, University of New South Wales, Sydney, Australia
| | - Jennifer Sandbach
- Department of Ophthalmology, Prince of Wales Hospital, University of New South Wales, Sydney, Australia
| | - Dinesh Subedi
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Mark Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Torsten Thomas
- School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, Australia
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Ham B, Hwang HB, Jung SH, Chang S, Kang KD, Kwon MJ. Distribution and Diversity of Ocular Microbial Communities in Diabetic Patients Compared with Healthy Subjects. Curr Eye Res 2017; 43:314-324. [PMID: 29172724 DOI: 10.1080/02713683.2017.1406528] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE The aim of this study was to identify differences in the major (core vs. variable) microbial genera of human subjects with and without diabetes. METHODS Bacterial 16S rRNA genes obtained from conjunctival swabs of 19 healthy subjects and 30 diabetic patients were sequenced using the Illumina MiSeq platform, and the sequencing data were analyzed using QIIME 1.9.1. To elucidate the microbial diversity in the ocular surface (OS), test programs from various bioinformatics domains were used. RESULTS Diversity index and rarefaction analysis showed that the microbial community of the diabetic patients was more diverse than that of the healthy subjects. Proteobacteria, Firmicutes, Actinobacteria, Cyanobacteria and Bacteroidetes were the dominant taxa present in the OS, and there was a significant difference in the relative abundance of the bacterial phyla between the diabetic patients and control subjects. Proteobacteria were more abundant in the diabetic group, whereas Firmicutes was more abundant in the control group. Analysis of bacterial taxa at the genus level showed that the core microbiome of diabetic patients comprised Acinetobacter, Burkholderia, Sphingomonas, and Ralstonia, whereas that of the controls comprised Bradyrhizobiaceae, Staphylococcus, Corynebacterium, Pseudomonas, Novosphingobium, Neisseriaceae, and Acinetobacter. CONCLUSIONS There was a significant difference in the microbial community composition between diabetic patients and healthy subjects. A high abundance of Acinetobacter in the OS of diabetic patients may arise from the unique characteristics of the OS compared with those of other organ surfaces.
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Affiliation(s)
- Baknoon Ham
- a Green School, Korea University , Seoul , Republic of Korea.,b Natural Product Research Center, Korea Institute of Science and Technology , Gangneung , Republic of Korea
| | - Hyung Bin Hwang
- c Department of Ophthalmology , Incheon St. Mary's Hospital The Catholic University of Korea , Incheon , Republic of Korea
| | - Sang Hoon Jung
- b Natural Product Research Center, Korea Institute of Science and Technology , Gangneung , Republic of Korea
| | - Sungyul Chang
- b Natural Product Research Center, Korea Institute of Science and Technology , Gangneung , Republic of Korea
| | - Kui Dong Kang
- c Department of Ophthalmology , Incheon St. Mary's Hospital The Catholic University of Korea , Incheon , Republic of Korea
| | - Man Jae Kwon
- a Green School, Korea University , Seoul , Republic of Korea.,d Department of Earth and Environmental Sciences , Korea University , Seoul , Republic of Korea
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Jhingan M, Balakrishnan D, Rani PK, Tyagi M, Joseph J. Microbiological Characteristics and Clinical Outcomes of Acinetobacter spp. Endophthalmitis with the First Reported Case of Acinetobacter haemolyticus Endophthalmitis. Semin Ophthalmol 2017; 33:477-481. [DOI: 10.1080/08820538.2017.1301498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Mahima Jhingan
- Kannuri Santhamma Centre for Vitreoretinal Diseases, L. V. Prasad Eye Institute, Hyderabad, India
| | - Divya Balakrishnan
- Kannuri Santhamma Centre for Vitreoretinal Diseases, L. V. Prasad Eye Institute, Hyderabad, India
| | - Padmaja Kumari Rani
- Kannuri Santhamma Centre for Vitreoretinal Diseases, L. V. Prasad Eye Institute, Hyderabad, India
| | - Mudit Tyagi
- Kannuri Santhamma Centre for Vitreoretinal Diseases, L. V. Prasad Eye Institute, Hyderabad, India
| | - Joveeta Joseph
- Jhaveri Microbiology Centre, L.V. Prasad Marg, Banjara Hills, Hyderabad, Telangana, India
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Abstract
Bacterial endophthalmitis is an infection and inflammation of the posterior segment of the eye which can result in significant loss of visual acuity. Even with prompt antibiotic, anti-inflammatory and surgical intervention, vision and even the eye itself may be lost. For the past century, experimental animal models have been used to examine various aspects of the pathogenesis and pathophysiology of bacterial endophthalmitis, to further the development of anti-inflammatory treatment strategies, and to evaluate the pharmacokinetics and efficacies of antibiotics. Experimental models allow independent control of many parameters of infection and facilitate systematic examination of infection outcomes. While no single animal model perfectly reproduces the human pathology of bacterial endophthalmitis, investigators have successfully used these models to understand the infectious process and the host response, and have provided new information regarding therapeutic options for the treatment of bacterial endophthalmitis. This review highlights experimental animal models of endophthalmitis and correlates this information with the clinical setting. The goal is to identify knowledge gaps that may be addressed in future experimental and clinical studies focused on improvements in the therapeutic preservation of vision during and after this disease.
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Affiliation(s)
- Roger A Astley
- Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Phillip S Coburn
- Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Salai Madhumathi Parkunan
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Michelle C Callegan
- Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Dean McGee Eye Institute, Oklahoma City, OK, USA.
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Talreja D, Kaye KS, Yu FS, Walia SK, Kumar A. Pathogenicity of ocular isolates of Acinetobacter baumannii in a mouse model of bacterial endophthalmitis. Invest Ophthalmol Vis Sci 2014; 55:2392-402. [PMID: 24644055 DOI: 10.1167/iovs.13-13401] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To determine the virulence properties of ocular isolates of Acinetobacter baumannii in causing endophthalmitis in a mouse model. METHODS Endophthalmitis was induced by intravitreal injections of the bacteria into C57BL/6 (B6) mouse eyes. The disease progression was monitored by ophthalmoscopic, electroretinography (ERG), histologic, cell death (TUNEL labeling), and microbiological parameters. The expression of cytokines/chemokines was checked by quantitative RT-PCR (qRT-PCR) and ELISA. Flow cytometry was used to determine cellular infiltration. The role of neutrophils was determined using neutropenic mice. The virulence traits (biofilm formation, adherence, and cytotoxicity) of the ocular isolates were tested using corneal epithelial cells. RESULTS Among the three clinical isolates and a standard ATCC 19606 strain tested, a biofilm producing multidrug resistant (MDR) strain of A. baumannii AB12 caused severe endophthalmitis (100% destruction of the eyes) leading to the loss of retinal function as assessed by ERG analysis. Elevated levels of inflammatory mediators (TNF-α, IL-1β, CXCL2, and IL-6) were detected in AB12-infected eyes. Histologic and TUNEL staining revealed increased retinal cell death and the flow cytometry data showed the presence of inflammatory cells, primarily neutrophils (CD45(+)/Ly6G(+)). Neutropenic mice showed an increased bacterial burden, reduced inflammatory response, and severe tissue destruction. CONCLUSIONS These results indicate that A. baumannii causes severe intraocular inflammation and retinal damage. Furthermore, neutrophils play an important role in the pathogenesis of A. baumannii endophthalmitis.
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Affiliation(s)
- Deepa Talreja
- Kresge Eye Institute, Wayne State University, Detroit, Michigan, United States
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