[Microbiological and infectious disease aspects of postoperative endophthalmitis]

Area of Science:

• Ophthalmology
• Microbiology
• Infectious Diseases

Background:

• Infectious endophthalmitis is a severe ocular emergency requiring prompt diagnosis and treatment.
• Gram-positive bacteria are the most common cause, but Gram-negative bacteria and fungi can also be implicated.
• Emerging antibiotic resistance necessitates updated treatment strategies.

Purpose of the Study:

• To review recent advancements in the microbiological causes of endophthalmitis.
• To summarize current diagnostic techniques for identifying causative agents.
• To discuss evolving treatment options and perioperative antibiotic prophylaxis.

Main Methods:

• Review of current literature on endophthalmitis etiology, diagnostics, and treatment.
• Analysis of diagnostic methods including Gram staining, culturing, and polymerase chain reaction (PCR)-based assays.
• Evaluation of antibiotic treatment regimens and prophylaxis strategies.

Main Results:

• Gram-positive bacteria (staphylococci, streptococci, enterococci) are predominant pathogens.
• Gram-negative bacteria (e.g., Klebsiella pneumoniae, Pseudomonas aeruginosa) and fungi are less common causes.
• Advanced diagnostics like PCR improve pathogen detection rates, enabling targeted therapy.

Conclusions:

• Accurate microbiological diagnosis is key for effective endophthalmitis management.
• Intravitreal and intravenous antibiotics, commonly vancomycin and ceftazidime, are standard treatments.
• Understanding emerging resistance patterns is vital for optimizing perioperative antibiotic prophylaxis and treatment protocols.