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Das AV, Dave VP, Tyagi M, Joseph J. Microbiological Landscape and Epidemiology of Endophthalmitis in Children and Adolescents in a Multi-Tier Ophthalmology Network in India: An Electronic Medical Record-Driven Analytics Report. Ocul Immunol Inflamm 2024:1-7. [PMID: 38241631 DOI: 10.1080/09273948.2023.2298932] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/19/2023] [Indexed: 01/21/2024]
Abstract
PURPOSE To study the epidemiology and microbiological landscape in patients (≤21 yrs) diagnosed with endophthalmitis across a multi-tier ophthalmology network in India. METHODS This cross-sectional hospital-based study included 1,041 patients (≤21 yrs) diagnosed with endophthalmitis, between April 2012 and May 2022. The data were collected using an electronic medical record system. RESULTS Bacteria (24%) was the most common etiology followed by fungus (2%). The majority of the patients were male (66%) with a mean age of 8.37 ± 5.99 years. The most common age group was middle childhood (6-11 years) with 365 (35.06%) patients. The patients were more commonly from the lower socio-economic status (60.81%) and urban geography (49%). The common cause of endophthalmitis was trauma (59.33%) and amongst the 279 culture positive eyes, the predominant bacteria isolated was Streptococcus pneumoniae followed by Bacillus species and fungus included predominantly Aspergillus and Candida species. The most common surgical intervention performed was intraocular antibiotics (74%) followed by pars plana vitrectomy (52%). CONCLUSION The most common etiology of endophthalmitis in children is bacterial and traumatic in nature and presented from the lower socio-economic status. A half of the eyes warranted a vitreo-retinal surgical intervention. .
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Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart EMR & AEye, LV Prasad Eye Institute, Hyderabad, India
- Indian Health Outcomes, Public Health and Economics Research Centre, Hyderabad, India
| | - Vivek Pravin Dave
- Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, India
| | - Mudit Tyagi
- Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, India
| | - Joveeta Joseph
- Jhaveri Microbiology Centre, LV Prasad Eye Institute, Hyderabad, India
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Martinod M, Bost-Bru C, Mortamet G. Endogenous endophthalmitis as a severe complication following a Streptococcus pyogenes infection. Arch Pediatr 2020; 27:506-8. [PMID: 33011024 DOI: 10.1016/j.arcped.2020.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 04/14/2020] [Accepted: 08/11/2020] [Indexed: 11/23/2022]
Abstract
The diagnosis of endogenous endophthalmitis is challenging. We report a pediatric case of endogenous endophthalmitis due to Streptococcus pyogenes angina. A previously healthy 33-month-old child presented to the emergency department with a history of fever and fatigue related to bacterial angina. On physical examination, an opalescent cornea was noticed and the diagnosis of endogenous endophthalmitis was confirmed by the pediatric ophthalmologist. Streptococcus pyogenes was found in blood culture and in the anterior chamber fluid. There was an adverse outcome with posterior vitrectomy and eye atrophy. Since endogenous endophthalmitis can lead to a poor visual outcome, urgent therapeutic management is necessary.
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Yang Y, Lin L, Li Y, Jiang Z, Li C, Liu M, Duan F, Lin X. Etiology, microbiological isolates, and antibiotic susceptibilities in culture-proven pediatric endophthalmitis: a 9-year review. Graefes Arch Clin Exp Ophthalmol 2020; 259:197-204. [PMID: 32808064 PMCID: PMC7790763 DOI: 10.1007/s00417-020-04866-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 07/21/2020] [Accepted: 07/27/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose To analyze the etiology, microbiological isolates, and antibiotic susceptibilities of endophthalmitis in pediatric patients. Methods Patients aged < 18 years with culture-positive endophthalmitis in Zhongshan Ophthalmic Center between January 2010 and December 2018 were included retrospectively. Results A total of 127 patients (127 eyes) were included, and 108 (85%) had posttraumatic endophthalmitis. Streptococcus (21.4%), coagulase-negative Staphylococcus (14.5%), Aspergillus (6.9%), and Bacillus cereus (5.3%) were the common organisms. The proportion of Streptococcus decreased with age (40.0% in 0–3 years, 16.3% in 4–12 years, and 6.3% in 13–17 years), while coagulase-negative Staphylococcus increased from 5.7% to 18.8%. Overall, fluoroquinolones achieved the highest antibiotic susceptibility rate (> 95%), while the susceptibility of isolated bacteria to tobramycin and cefazolin was only 60.2% and 59.4%, respectively. The susceptibility rates of Gram-positive cocci to cephalosporins were nearly 90%. For Gram-negative bacilli, susceptibility to neomycin was 91.3%. Conclusion Trauma was the main etiology for pediatric endophthalmitis. Although Streptococcus was the most prevalent organism in general, the dominant pathogen varied with age, which merits clinical attention. Fluoroquinolones showed the highest antibiotic efficacy; however, commonly used antibiotics tobramycin and cefazolin showed relatively low antibiotic susceptibility. Thus, antibiotic resistance in pediatric populations merits clinical attention.
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Affiliation(s)
- Yao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, China
| | - Lixia Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, China
| | - Yujie Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, China
| | - Zhaoxin Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, China
| | - Cheng Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, China
| | - Manli Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, China
| | - Fang Duan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, China.
| | - Xiaofeng Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, China.
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Qureshi A, Ashworth J, Sharma V, Ivanova T. Favourable outcome in paediatric endogenous endophthalmitis secondary to Neisseria meningitidis following pars plana vitrectomy. BMJ Case Rep 2020; 13:13/6/e233133. [PMID: 32587116 DOI: 10.1136/bcr-2019-233133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/09/2023] Open
Abstract
Paediatric endogenous endophthalmitis is an uncommon but potentially devastating intraocular infection which should not be missed. Often cases present to the accident and emergency department. Accurate and prompt assessment is key in saving sight and life. We present one such case and how it was surgically managed.
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Affiliation(s)
- Amreen Qureshi
- Ophthalmology Department, Manchester Royal Eye Hospital, Manchester, UK
| | - Jane Ashworth
- Ophthalmology Department, Manchester Royal Eye Hospital, Manchester, UK
| | - Vinod Sharma
- Ophthalmology Department, Manchester Royal Eye Hospital, Manchester, UK
| | - Tsveta Ivanova
- Ophthalmology Department, Manchester Royal Eye Hospital, Manchester, UK
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Lugga A, Ibrahim N, Ibrahim A, Paret S. Loss of both eyes from endogenous endophthalmitis in a term neonate with pseudomonas sepsis. J Clin Neonatol 2020. [DOI: 10.4103/jcn.jcn_114_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Maitray A, Rishi E, Rishi P, Gopal L, Bhende P, Ray R, Therese KL. Endogenous endophthalmitis in children and adolescents: Case series and literature review. Indian J Ophthalmol 2019; 67:795-800. [PMID: 31124489 PMCID: PMC6552604 DOI: 10.4103/ijo.ijo_710_18] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: To study the clinical and microbiological profile, treatment modalities, and anatomical and functional outcomes among children and adolescents with endogenous endophthalmitis (EE) at a tertiary eye care centre in India. Methods: Medical records of subjects <18 years, presenting with EE from 1997 to 2007 were reviewed. Cases where the causative organism was identified were included. Treatment regimen included systemic antibiotics, vitrectomy, intravitreal antibiotics, and enucleation. Systemic evaluation to identify the source of infection was done by an internist. Microbiological analysis of blood, urine, and ocular specimens was done. The favorable anatomical outcome was defined as the attached retina, with controlled intraocular pressure and clear media at the last follow up. The favorable functional outcome was defined as vision >3/60 on the final follow up. Univariate regression analysis was done to identify factors predicting functional outcome. Results: Thirty eyes of 30 subjects (23 (77%) males) were studied. The mean age at presentation was 6.8 years (range=1–16 years). Fever was evident in four (13%) and blood culture was negative in all cases. Gram-positive organisms were identified in 11 (37%) eyes, fungi in 3 (10%), and toxocara in 8 (27%) eyes. Twenty-three (77%) eyes underwent vitrectomy. Favorable functional and anatomical outcomes were achieved in 9 (30%) and 12 (40%) eyes, respectively. Eyes undergoing vitrectomy showed significant correlation with good functional outcome (P = 0.05). Conclusion: EE is under-reported and not well studied in children. The absence of systemic features may be evident in a developing country with over the counter availability of antibiotics. Gram-positive infections are common and vitrectomy is a beneficial modality of treatment.
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Affiliation(s)
- Aditya Maitray
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Ekta Rishi
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Pukhraj Rishi
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Lingam Gopal
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Pramod Bhende
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Rupak Ray
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Kuzhanthai Lily Therese
- Department of Microbiology, Larsen and Toubro Microbiology Research Centre, Vision Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
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Zone Abid I, Abid F, Ben Ameur S, Belhadj R, Trigui A, Hachicha M, Feki J. [Bilateral Presentation of neonatal Endogenous Endophthalmitis due to Pseudomonas Aeruginosa]. J Fr Ophtalmol 2019; 42:e289-e291. [PMID: 31130391 DOI: 10.1016/j.jfo.2019.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 01/16/2019] [Accepted: 01/23/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Imen Zone Abid
- Service d'Ophtalmologie, Hôpital Habib Bourguiba, Sfax, Tunisie; Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie.
| | - Fatma Abid
- Service d'Ophtalmologie, Hôpital Habib Bourguiba, Sfax, Tunisie; Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie
| | - Salma Ben Ameur
- Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie; Service de pédiatrie, Hôpital Hédi Chaker, Sfax, Tunisie
| | - Rim Belhadj
- Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie; Service de pédiatrie, Hôpital Hédi Chaker, Sfax, Tunisie
| | - Amira Trigui
- Service d'Ophtalmologie, Hôpital Habib Bourguiba, Sfax, Tunisie; Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie
| | - Mongia Hachicha
- Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie; Service de pédiatrie, Hôpital Hédi Chaker, Sfax, Tunisie
| | - Jamel Feki
- Service d'Ophtalmologie, Hôpital Habib Bourguiba, Sfax, Tunisie; Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie
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Richardson KM, Chen KS, Goubeaux DL, Atkinson CS, Poulose A, Woods G, Goldman JL. A 16-Year-Old Girl With Eye Pain. J Pediatric Infect Dis Soc 2019; 8:77-79. [PMID: 29688511 DOI: 10.1093/jpids/piy037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/06/2018] [Indexed: 11/13/2022]
Affiliation(s)
- Katherine M Richardson
- Division of Infectious Diseases, Children's Mercy Kansas City, Missouri.,Department of Pediatrics, Children's Mercy Kansas City, Missouri
| | - Kevin S Chen
- Department of Ophthalmology, Children's Mercy Kansas City, Missouri.,School of Medicine, University of Missouri-Kansas City
| | - Derrick L Goubeaux
- Department of Pediatrics, Children's Mercy Kansas City, Missouri.,Department of Hematology/Oncology, Children's Mercy Kansas City, Missouri
| | - C Scott Atkinson
- Department of Ophthalmology, Children's Mercy Kansas City, Missouri.,School of Medicine, University of Missouri-Kansas City
| | - Abraham Poulose
- Department of Ophthalmology, Children's Mercy Kansas City, Missouri.,School of Medicine, University of Missouri-Kansas City
| | - Gerald Woods
- Department of Pediatrics, Children's Mercy Kansas City, Missouri.,Department of Hematology/Oncology, Children's Mercy Kansas City, Missouri
| | - Jennifer L Goldman
- Division of Infectious Diseases, Children's Mercy Kansas City, Missouri.,Department of Pediatrics, Children's Mercy Kansas City, Missouri.,School of Medicine, University of Missouri-Kansas City
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