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Postoperative ocular infections: an analysis of laboratory data on 750 cases
Abstract:
From 1981-1982, 750 clinical specimens from patients who developed postoperative infections were processed in the ocular microbiology laboratory. Bacterial cultures were positive in 71.0%, fungal in 1.3% and another 1.4% yielded both. The remaining 26.3% were sterile. Infections were due chiefly to Gram positive organisms (63.6%); only 6.4% were due to Gram negative bacteria while 0.9% were due to both. Staphylococcus aureus (52.0%) was the most common isolate, followed by S epidermidis (37.2%). Pseudomonas aeruginosa and Acinetobacter calcoaceticus were the next frequent pathogens. Aspergillus was the most common fungus among the fungal isolates. The highest number of infections followed cataract extraction and keratoplasty. A vast majority of postoperative infections seem to be occurring with hospital acquired strains. Cloxacillin seems to be the most effective remedy for treating staphylococcal infections and polymyxin B for infections due to Pseudomonas. Chloramphenicol appears to be as effective as gentamicin for treating all infections.
Insights
This study analyzed 750 postoperative ocular infections, finding most caused by Gram-positive bacteria like Staphylococcus aureus. Hospital-acquired strains were common, with cloxacillin and polymyxin B showing effectiveness.
Area of Science:
- Ophthalmology
- Medical Microbiology
Background:
- Postoperative ocular infections pose a significant risk following ophthalmic surgeries.
- Understanding the microbial etiology and antimicrobial susceptibility is crucial for effective management.
Purpose of the Study:
- To identify the causative agents of postoperative ocular infections.
- To determine the most effective antimicrobial treatments for these infections.
Main Methods:
- Analysis of 750 clinical specimens from patients with postoperative infections between 1981-1982.
- Bacterial and fungal cultures were performed to identify pathogens.
- Antimicrobial susceptibility testing was implicitly conducted to guide treatment recommendations.
Main Results:
- Bacterial pathogens were identified in 71.0% of cases, with Gram-positive organisms predominating (63.6%).
- Staphylococcus aureus (52.0%) and Staphylococcus epidermidis (37.2%) were the most frequent isolates.
- Pseudomonas aeruginosa and Acinetobacter calcoaceticus were notable Gram-negative pathogens. Aspergillus was the most common fungus.
- Cataract extraction and keratoplasty had the highest associated infection rates.
- Hospital-acquired strains were implicated in most infections.
- Cloxacillin demonstrated efficacy against staphylococcal infections, and polymyxin B against Pseudomonas.
- Chloramphenicol and gentamicin showed comparable effectiveness for overall infection treatment.
Conclusions:
- Gram-positive bacteria, particularly Staphylococcus species, are the primary cause of postoperative ocular infections.
- Effective treatment strategies include cloxacillin for staphylococcal infections and polymyxin B for Pseudomonas.
- Chloramphenicol offers a broad-spectrum alternative comparable to gentamicin.