Nosocomial Acute-Onset Postoperative Endophthalmitis at a University Teaching Hospital (2002-2009)
Nosocomial Acute-Onset Postoperative Endophthalmitis at a University Teaching Hospital (2002-2009)
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DOI：
10.1016/j.ajo.2010.04.010
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发表时间：
2010-09-01
影响因子：
4.2
通讯作者：
Alfonso, Eduardo C.
中科院分区：
文献类型：
--
作者：
Wykoff, Charles C.;Parrott, M. Brandon;Alfonso, Eduardo C.
“目的：评估学术医学中心发生的急性发作的术后眼内炎，并比较过去25年中单一机构的发病率。设计：回顾，连续的病例系列。方法：回顾2002年至2009年在巴斯康姆-帕尔默眼科研究所接受手术的所有被诊断为急性发作的术后医院内眼内炎患者的病历。结果：8年内急性发作的术后眼内炎的发生率为0.025%(14/56672例眼内手术)。白内障手术发生率为0.028%(8/28568)，平坦部玻璃体切割术为0.011%(2/18492)。两例PPV眼内炎患者均接受了20口径的手术，无一例接受了小口径、经结膜的PPV(n=2262)。穿透性角膜移植术后发生3例(0.108%)。最常见的细菌分离物是葡萄球菌(n=7，50%)。早期治疗包括眼球穿刺术(n=8，57%)或玻璃体切除(n=5，36%)，联合眼内注射抗生素(n=14,100%)。13眼(93%)应用万古霉素和头孢他啶，9眼(%)首次应用眼内激素。最终视力<20/200者9眼(%)，无光感2眼(14%)。自1984年以来，该院术后急性眼内炎的发生率有显著下降趋势(1984年-1994年：0.09%；1995年-2001年：0.05%；2002年-2009年：0.025%；P
" PURPOSE: To evaluate acute-onset postoperative endophthalmitis occurring at an academic medical center and to compare rates over the last 25 years at a single institution.DESIGN: Retrospective, consecutive case series.METHODS: Medical records were reviewed for all patients diagnosed with acute-onset postoperative nosocomial endophthalmitis from 2002 through 2009 associated with surgery at Bascom Palmer Eye Institute.RESULTS: The 8-year frequency of acute-onset postoperative endophthalmitis was 0.025% (14 of 56 672 intraocular surgeries). The rate was 0.028% (8/28 568) for cataract surgery and 0.011% (2/18 492) for pars plana vitrectomy (PPV). Both PPV endophthalmitis cases followed 20-gauge surgery and no cases followed small-gauge, transconjunctival PPV (n = 2262). Three cases occurred following penetrating keratoplasty (3/ 2788, 0.108%). The most common bacterial isolate was Staphylococcus (n = 7, 50%). Initial treatment involved ocular paracentesis (n = 8, 57%) or vitrectomy (n = 5, 36%), in combination with injection of intraocular antibiotics (n = 14, 100%). Vancomycin and ceftazidime were used in 13 eyes (93%) and intraocular steroids were given initially to 9 eyes (64%). Final visual acuity was >= 20/200 in 9 eyes (64%) and 2 eyes (14%) were no light perception. At this institution since 1984, there has been a statistically significant trend for a decreasing rate of acute-onset postoperative endophthalmitis (1984- 1994: 0.09%; 1995-2001: 0.05%; 2002-2009: 0.025%; P