Comparison of the aetiology, microbiological isolates and antibiotic susceptibilities of endophthalmitis between children and adults in southern China: a retrospective, cohort study

BMJ Open. 2024 Nov 13;14(11):e085021. doi: 10.1136/bmjopen-2024-085021.

Abstract

Objectives: To compare aetiology, microbiological isolates and antibiotic susceptibilities of endophthalmitis between children and adults.

Design: Retrospective observational study.

Participants: Patients admitted to Zhongshan Ophthalmic Center between January 2013 and December 2019 with clinically diagnosed endophthalmitis were included.

Outcome measures: The aetiology, microbiological isolates and antibiotic susceptibilities of endophthalmitis were analysed.

Results: Of 1803 patients, 430 (23.8%) were aged ≤16 years. In both children and adults, the main aetiology was trauma (85.6% vs 64.7%, p<0.05). Streptococcus species (spp.) (28.8%) were most prevalent in paediatric post-traumatic endophthalmitis; whereas, coagulase-negative staphylococci (36.9%) were dominant in adults. In postoperative endophthalmitis, all children had bacterial infections, while fungal infections accounted for 12.5% in adults. In endogenous endophthalmitis caused by fungi, Candida was most prevalent in adults (26.9%); whereas, all causative fungi involved filamentous fungi in children. Isolated bacteria in children presented a higher susceptibility in 7 of 11 antibiotics compared with those in adults. Levofloxacin had the highest susceptibility rate in children (97.9%), and ofloxacin had the highest susceptibility rate in adults (90.6%).

Conclusion: The main aetiology was trauma, with a higher proportion in children than in adults. The microbial profile of paediatric endophthalmitis was different from those of adults. Susceptibilities of causative bacteria to most antibiotics were higher in children than in adults.

Keywords: EPIDEMIOLOGIC STUDIES; INFECTIOUS DISEASES; OPHTHALMOLOGY; PAEDIATRICS.

Publication types

  • Observational Study
  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Child
  • Child, Preschool
  • China / epidemiology
  • Endophthalmitis* / drug therapy
  • Endophthalmitis* / epidemiology
  • Endophthalmitis* / microbiology
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / epidemiology
  • Eye Infections, Bacterial / microbiology
  • Eye Infections, Fungal / drug therapy
  • Eye Infections, Fungal / epidemiology
  • Eye Infections, Fungal / microbiology
  • Female
  • Humans
  • Infant
  • Male
  • Microbial Sensitivity Tests*
  • Middle Aged
  • Retrospective Studies
  • Young Adult

Substances

  • Anti-Bacterial Agents