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The Endophthalmitis Vitrectomy Study. Relationship between clinical presentation and microbiologic spectrum

M W Johnson1, B H Doft, S F Kelsey

  • 1W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, USA.

Ophthalmology
|February 1, 1997
PubMed
Summary

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Clinical presentation features of acute postoperative endophthalmitis can suggest likely microbiologic culture results. However, these findings are not strong enough to guide initial antibiotic choices for endophthalmitis treatment.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Acute postoperative endophthalmitis is a severe intraocular infection following cataract surgery.
  • Early diagnosis and appropriate treatment are crucial to preserve vision.

Purpose of the Study:

  • To investigate the correlation between clinical presentation features of acute postoperative endophthalmitis and microbiologic culture results.
  • To determine if clinical signs can predict the causative microorganisms.

Main Methods:

  • A total of 420 patients with endophthalmitis post-cataract surgery were evaluated.
  • Aqueous and vitreous specimens were cultured and results categorized (gram-positive, gram-negative, etc.).
  • Clinical features were analyzed for correlation with culture outcomes.

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Main Results:

  • Eleven clinical features significantly correlated with the microbiologic spectrum (P < 0.05).
  • Corneal infiltrate, wound abnormalities, afferent pupillary defect, and early symptom onset predicted gram-negative or other gram-positive isolates.
  • Diabetes mellitus was linked to gram-positive, coagulase-negative micrococci; eye pain was not a predictor.

Conclusions:

  • Presenting characteristics of endophthalmitis may help predict likely culture results.
  • These predictions are insufficient to guide initial empiric intravitreal antibiotic selection.