Culture-Proven Endophthalmitis After Intravitreal Injection: A 10-Year Analysis

Ophthalmic Surg Lasers Imaging Retina. 2019 Jan 1;50(1):33-38. doi: 10.3928/23258160-20181212-05.

Abstract

Background and objective: To report on the microbiology, management, and visual outcomes of intravitreal injection (IVI)-associated, culture-proven endophthalmitis.

Patients and methods: All patients seen at a tertiary referral center with culture-proven endophthalmitis associated with an IVI between June 2007 and July 2017 were included in this retrospective analysis.

Results: Thirty-five patients with culture-positive endophthalmitis following IVI were identified. All gram-positive organisms (34 of 35) were susceptible to vancomycin. Cases due to pathogens associated with oral or respiratory flora were common (31.4%, n = 11), presented earlier (2.0 days vs. 4.6 days, P < .001), were more likely to undergo pars plana vitrectomy (81.8% vs. 25.0%, P = .002) and had worse visual acuity outcomes.

Conclusion: IVI-associated endophthalmitis pathogens and anti-microbial susceptibilities in the Pacific Northwest are similar to those reported from other geographic locations. Bacteria associated with the oral and respiratory flora are common isolates that result in a more aggressive course and worse visual outcomes. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:33-38.].

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Endophthalmitis / diagnosis
  • Endophthalmitis / microbiology*
  • Endophthalmitis / therapy
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / microbiology*
  • Eye Infections, Bacterial / therapy
  • Female
  • Follow-Up Studies
  • Forecasting*
  • Gram-Negative Bacteria / isolation & purification*
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Negative Bacterial Infections / microbiology*
  • Gram-Negative Bacterial Infections / therapy
  • Humans
  • Male
  • Retrospective Studies
  • Vancomycin / administration & dosage*
  • Visual Acuity
  • Vitrectomy / methods*

Substances

  • Anti-Bacterial Agents
  • Vancomycin