Burkholderia cepacia endophthalmitis: clinico-microbiologic profile and outcomes

To report the clinical presentations, antibiotic sensitivities, and outcomes of Burkholderia cepacia endophthalmitis.

Retrospective, consecutive, noncomparative, interventional case series. We reviewed case records of culture-proven B. cepacia endophthalmitis from the endophthalmitis registry between January 2003 and December 2008. Data collected included the cause of endophthalmitis, time of presentation, presenting visual acuity, initial surgical procedures performed, clinical response, secondary interventions, antibiotic sensitivity of the organism, and final visual acuity.

Burkholderia cepacia was the causative agent in 14 (1.8%) of the 744 culture-positive cases. Endophthalmitis occurred after cataract surgery in nine, penetrating keratoplasty in one, and trauma in four patients. Acute- and delayed-onset postoperative endophthalmitis presentation was noted in eight and two patients, respectively. Susceptibility of isolates to ceftazidime and ciprofloxacin was 78.6%. Of the isolates, 50% were sensitive to amikacin. Secondary interventions were carried out in 12 eyes. Final best-corrected visual acuity was 20/200 or better in 6 (41.66%) of 14 eyes.

Burkholderia cepacia can present as posttraumatic, acute-onset and delayed-onset postoperative endophthalmitis. Oral ciprofloxacin and intravitreal ceftazidime may be administered while awaiting the sensitivity reports. Recurrence and/or persistence of infection are not uncommon. Like other gram-negative organisms causing endophthalmitis, it is also associated with poor visual outcomes.