Fungal Endophthalmitis Outbreak after Cataract Surgery, South Korea, 2020

Area of Science:

• Ophthalmology
• Infectious Diseases
• Public Health

Background:

• An unusual rise in fungal endophthalmitis post-cataract surgery was reported in South Korea in November 2020.
• This prompted an urgent outbreak investigation by the Korea Disease Control and Prevention Agency.

Purpose of the Study:

• To identify the causative agent and source of the fungal endophthalmitis outbreak.
• To determine the association between specific ocular viscoelastic devices (OVDs) and infection risk.

Main Methods:

• Epidemiological investigation involving 156 reported cases (62 confirmed, 94 probable).
• Microbiological analysis, including isolation and molecular identification of fungal pathogens from clinical samples and OVDs.
• Risk assessment comparing infection rates associated with different OVD manufacturers.

Main Results:

• Fusarium oxysporum was identified as the causative agent in confirmed cases.
• A significantly higher risk ratio (86.0) for fungal endophthalmitis was associated with OVDs from a specific manufacturer (Company A).
• A contaminated lot of OVDs was identified as the source of the outbreak.

Conclusions:

• The outbreak was attributed to contaminated OVDs, necessitating their discontinued use.
• Early recognition and coordinated governmental response are crucial for mitigating risks of fungal endophthalmitis outbreaks.