Clinical Etiologies, Microbial Spectrum, Antibiotic Susceptibilities, and Visual Acuity Outcomes of Acute Endophthalmitis.
Clinical Etiologies, Microbial Spectrum, Antibiotic Susceptibilities, and Visual Acuity Outcomes of Acute Endophthalmitis.
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急性眼内炎的临床病因、微生物谱、抗生素敏感性和视力结果。
DOI：
10.1089/jop.2018.0074
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Adelman,RonA
中科院分区：
文献类型：
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作者：
Lu,LouiseJ;Chen,Xuejing;Adelman,RonA
目的：报道与急性眼内炎相关的临床病原学、微生物谱、抗生素耐药性和视力(VA)结果。方法：对一家三级转诊中心6年间(2011-2016)的眼内炎患者的国际疾病分类(ICD)-9和ICD-10编码进行了回顾。对临床病原学、微生物谱、抗生素敏感性和耐药性以及视力结果进行复习。结果：94例经细菌培养证实的眼内炎患者的病历被复习。外源性眼内炎占68.8%，内源性占31.2%。外源性眼内炎最常见的诱因是角膜溃疡的进展和白内障摘除术后的感染。病原菌以凝固酶阴性葡萄球菌为主(30.9%)，其次为金黄色葡萄球菌(23.4%)。真菌分离最多的是假丝酵母菌。革兰氏阳性菌对万古霉素的敏感率为96.7%，对青霉素的敏感率为28.8%。革兰氏阴性菌对抗生素的敏感率总体很高，在分离的培养样本中敏感率为90%。62.5%的患者最终视力达到或超过20/400。结论：眼内炎最常见的临床病因是由于白内障摘除术后角膜溃疡的进展和术后感染。引起眼内炎的病原体主要由革兰氏阳性细菌(特别是凝固酶阴性葡萄球菌)组成。大多数眼内炎患者治疗后Va均有改善。
Purpose:The purpose of this study was to report the clinical etiologies, microbial spectrum, antibiotic resistance, and visual acuity (VA) outcomes associated with acute endophthalmitis.Methods:A retrospective chart review of patients with International Classification of Diseases (ICD)-9 and ICD-10 codes for endophthalmitis over a 6-year period (2011–2016) at a tertiary referral center was performed. The clinical records were reviewed to evaluate clinical etiologies, microbial spectrum, antibiotic susceptibilities and resistance, and visual outcomes.Results:Medical records of 94 patients treated for culture-proven endophthalmitis were reviewed. The etiologies of endophthalmitis were exogenous in 68.8% of cases and endogenous in 31.2% of cases. The most common inciting factors for exogenous endophthalmitis were progression of corneal ulcer and postoperative infection after cataract extraction. The microbial spectrum of causative organisms was dominated by coagulase-negativeStaphylococcus(30.9%), followed byStaphylococcus aureus(23.4%). The most frequent fungal isolates wereCandidaspecies. Antibiotic susceptibilities of gram-positive bacteria ranged from 96.7% for vancomycin to 28.8% for penicillin G. Antibiotic susceptibilities of gram-negative bacteria were overall very high, with >90% susceptibility among isolated culture samples. Final VA outcomes of 20/400 or better were reported in 62.5% of patients.Conclusions:The study demonstrates that the most frequent clinical etiology of endophthalmitis was exogenous due to progression of corneal ulcer and postoperative infection after cataract extraction. The spectrum of pathogens causing endophthalmitis is composed of mainly Gram-positive organisms (particularly coagulase-negativeStaphylococcus). VA was improved in the majority of patients after treatment for endophthalmitis.