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Postoperative endophthalmitis caused by an Enterobacter species
G E Mirza1, S Karaküçük, M Doğanay
1Department of Ophthalmology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
The Journal of Hospital Infection
|March 1, 1994
Summary
A surgical contamination event led to bacterial endophthalmitis in seven eyes following various eye surgeries. Improperly sterilized cotton swabs were identified as the source, highlighting the critical need for strict sterile procedures.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Surgical Safety
Background:
- Bacterial endophthalmitis is a severe intraocular infection following eye surgery.
- Maintaining strict sterile techniques is paramount to prevent postoperative complications.
Observation:
- Seven eyes across six patients developed acute bacterial endophthalmitis within 24 hours of various intraocular surgeries.
- Vitreous cultures consistently identified Enterobacter species as the causative agent.
Findings:
- Manual preparation of cotton swabs, bypassing standard autoclaving, was identified as the source of Enterobacter contamination.
- Despite aggressive antibiotic therapy (systemic, subconjunctival, intravitreal), visual outcomes were poor, with only one eye retaining useful vision.
Implications:
- This outbreak underscores the critical importance of rigorous adherence to sterile processing protocols for all surgical materials.
- Failure to implement proper autoclaving procedures can have devastating consequences for patient vision and necessitate globe evisceration.