META-ANALYSIS OF ENDOPHTHALMITIS AFTER INTRAVITREAL INJECTION OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR AGENTS Causative Organisms and Possible Prevention Strategies
META-ANALYSIS OF ENDOPHTHALMITIS AFTER INTRAVITREAL INJECTION OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR AGENTS Causative Organisms and Possible Prevention Strategies
复制标题
DOI：
10.1097/iae.0b013e31820a67e4
复制
发表时间：
2011-04-01
影响因子：
3.3
通讯作者：
McCannel, Colin A.
中科院分区：
文献类型：
--
作者：
McCannel, Colin A.
目的：报告玻璃体内注射抗血管内皮生长因子药物后眼内炎的发生率、病原微生物谱及可能的预防策略。方法：对2005年至2009年美国文献报道玻璃体内注射抗血管内皮生长因子药物后眼内炎细菌分离株进行Meta分析，并与美国眼内手术后眼内炎细菌分离株的报道进行比较。 105,536 次注射中，有 52 次发生玻璃体内注射后发生眼内炎 (0.049%)（95% 置信区间 [CI]，0.038-0.065%）。在 50 例细菌培养分离的眼内炎病例中，24 例（48.0% [95% CI, 34.8-61.5%]）培养阴性，26 例（52% [95% CI, 38.5-65.2%]）培养阳性。在 26 株培养阳性分离株中，致病菌为凝固酶阴性葡萄球菌 17 例（65.4% [95% CI, 46.0-80.6%]）、链球菌 8 例（30.8% [95% CI, 16.5-50.2%]）和蜡样芽孢杆菌 1 例（3.8% [95%]）。 CI，0.9-19.0%]）。在眼内炎玻璃体切除术研究（226 株分离株中的 29 株，9.0% [95% CI，6.3-12.6%]，P = 0.005）中，玻璃体内注射后的链球菌种类明显高于眼内手术后，一份关于透明角膜白内障手术眼内炎的报告（73 株分离株中的 6 株，8.2% [95% CI， 3.9-16.8%]，P = 0.022），以及一份关于玻璃体切除术后眼内炎的报告，无链球菌属病例。结论：玻璃体内注射抗血管内皮生长因子后，链球菌分离株的出现率大约是眼内手术后的三倍。考虑尽量减少口咽飞沫传播的策略可能包括避免说话、咳嗽、打喷嚏或佩戴外科口罩。视网膜 31：654-661，2011
Purpose: To report the rates of endophthalmitis and the spectrum of causative organisms after intravitreal injection of anti-vascular endothelial growth factor agents and possible prevention strategies.Methods: Meta-analysis of the U. S. literature from 2005 to 2009 reporting endophthalmitis bacterial isolates after intravitreal injection of anti-vascular endothelial growth factor agents and comparison with reports of endophthalmitis bacterial isolates after intraocular surgery in the United States.Results: Endophthalmitis after intravitreal injection occurred in 52 of 105,536 injections (0.049%) (95% confidence interval [CI], 0.038-0.065%). Among 50 cases of endophthalmitis with bacterial culture isolates, 24 (48.0% [95% CI, 34.8-61.5%]) were culture negative and 26 (52% [95% CI, 38.5-65.2%]) were culture positive. Among the 26 culture-positive isolates, causative organisms were coagulase-negative Staphylococcus in 17 cases (65.4% [95% CI, 46.0-80.6%]), Streptococcus species in 8 cases (30.8% [95% CI, 16.5-50.2%]), and Bacillus cereus in 1 case (3.8% [95% CI, 0.9-19.0%]). Streptococcus species were significantly more frequent after intravitreal injection than after intraocular surgery in the Endophthalmitis Vitrectomy Study (29 of 226 isolates, 9.0% [95% CI, 6.3-12.6%], P = 0.005), a report on clear corneal cataract surgery endophthalmitis (6 of 73 isolates, 8.2% [95% CI, 3.9-16.8%], P = 0.022), and a report on postvitrectomy endophthalmitis with no cases of Streptococcus species.Conclusion: Streptococcal isolates are approximately three times more frequent after intravitreal anti-vascular endothelial growth factor injection than after intraocular surgery. Strategies to consider minimizing oropharyngeal droplet transmission may include avoiding talking, coughing, and sneezing or wearing surgical masks. RETINA 31: 654-661, 2011