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Pathogen-Associated Visual Outcomes Following Postprocedure Endophthalmitis.

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Summary
This summary is machine-generated.

Virulent bacteria like Streptococcus cause worse outcomes in postprocedure endophthalmitis. Early identification of these pathogens is crucial for better visual results and fewer complications.

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Area of Science:

  • Ophthalmology
  • Infectious Diseases

Background:

  • Postprocedure acute endophthalmitis is a serious complication following intraocular procedures.
  • Pathogen virulence is a key factor influencing patient outcomes.

Purpose of the Study:

  • To analyze anatomic and functional outcomes in postprocedure acute endophthalmitis.
  • To stratify outcomes based on pathogen virulence using a large, multicenter dataset.

Main Methods:

  • Retrospective case series of 240 adult patients with postprocedure acute endophthalmitis (2012-2022).
  • Organisms classified as surface commensals (e.g., coagulase-negative Staphylococcus) or nonsurface commensals (e.g., Streptococcus, Enterococcus) as virulence proxies.
  • Visual acuity and complication rates compared between groups, adjusting for confounders.

Main Results:

  • Infections with nonsurface commensals led to significantly worse final visual acuity (logMAR 2.14 vs 0.77).
  • Higher rates of interventions (27.5% vs 10.1%), phthisis (15.4% vs 1.1%), and enucleation/evisceration (12.8% vs 0%) were observed with virulent pathogens.
  • Virulent organisms remained independently associated with poorer visual outcomes in postinjection endophthalmitis.

Conclusions:

  • Infections with virulent, nonsurface commensal organisms are linked to worse outcomes in postprocedure endophthalmitis.
  • Pathogen-informed management strategies are supported by these findings.
  • Timely identification of virulent organisms is essential for optimizing patient care.