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[Endophthalmitis in Japan--a nationwide study with reference to type and etiology]
1Department of Ophthalmology, Yokohama City University School of Medicine, Japan.
Abstract:
A nationwide clinical study on bacterial and fungal endophthalmitis was done with special reference to their type and etiology. Two hundred and eighty cases of endophthalmitis were reviewed. All cases were divided into two categories such as exogenous (trauma, surgery, and ulcer) and endogenous (metastasis). Penetrating trauma was responsible for 93 cases (33.2%), surgery for 88 cases (31.4%), ulcer for 11 cases (3.9%) and metastasis for 88 cases (31.4%). Out of the 280 cases, 79 cases (28.2%) were microbiologically diagnosed through aqueous or vitreous tap or biopsy. The total numbers of isolated organisms amounted to 87 consisting of 43 Gram-positive bacteria, 30 Gram-negative bacteria and 14 fungi. The positive isolation was 31 out of 86 (36%) from the aqueous and 52 out of 103 (50%) from the vitreous. Exogenous types associated with trauma, surgery or ulcer were mainly caused by Gram-positive bacteria of 37 strains, led by coagulase-negative staphylococci in 14 cases. On the other hand, endogenous cases were mainly due to Gram-negative bacteria of 14 strains including Klebsiella pneumoniae in 5 cases, E. coli in 4 cases and fungi of 11 strains including candida spp in 9 cases.
Insights
This study analyzed 280 endophthalmitis cases, finding Gram-positive bacteria common in exogenous infections and Gram-negative bacteria/fungi in endogenous cases. Microbiological diagnosis confirmed various causative agents, guiding treatment strategies.
Area of Science:
- Ophthalmology
- Microbiology
- Clinical Medicine
Context:
- Endophthalmitis, an intraocular infection, poses a significant threat to vision.
- Understanding the causative agents and origins of endophthalmitis is crucial for effective management.
- This study provides a comprehensive overview of bacterial and fungal endophthalmitis in a nationwide clinical setting.
Purpose:
- To investigate the types and etiologies of bacterial and fungal endophthalmitis.
- To determine the microbiological profiles of exogenous and endogenous endophthalmitis.
- To identify the most prevalent microorganisms responsible for endophthalmitis.
Summary:
- A review of 280 endophthalmitis cases categorized them into exogenous (trauma, surgery, ulcer) and endogenous (metastasis) origins.
- Microbiological analysis of 79 cases revealed 87 isolates: 43 Gram-positive bacteria, 30 Gram-negative bacteria, and 14 fungi.
- Exogenous endophthalmitis was predominantly caused by Gram-positive bacteria (e.g., coagulase-negative staphylococci), while endogenous cases involved Gram-negative bacteria (e.g., Klebsiella pneumoniae, E. coli) and fungi (e.g., Candida spp.).
Impact:
- This research highlights the distinct microbiological patterns in exogenous versus endogenous endophthalmitis.
- Findings can inform targeted diagnostic and therapeutic approaches for clinicians.
- Establishes etiological data crucial for developing preventative strategies and improving patient outcomes in endophthalmitis management.