First Author: D.Loganathan UK
Co Author(s): A. Krishnan M. Damani 0 0 0 0 0 0 0 0 0
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To evaluate the organisms that are responsible for post-intravitreal endophthalmitis which would form the basis for the prevention. Any similarities in various organisms recognized at acute postoperative endophthalmitis.
This was part of audit performed in the Ophthalmology Department at Southend University Hospital NHS Foundation Trust.
Retrospective, interventional, non-randomized, without control study of 3738 various intravitreal injections namely Ranibizumab, Bevacizumab, Ozurdex, Triamcinolone, Ganciclovir in the treatment room settings over 18 months. Six cases post-intravitreal endophthalmitis were treated during this period. All had vitreous biopsy and intravitreal antibiotics with or without simultaneous intravitreal dexamethasone injection. Various combinations of tropical antibiotics, steroid and oral antibiotics were administrated depending on the clinical situations. All had close monitoring after the event.
All six cases presented with signs and symptoms of endophthalmitis following 2-41 days after intravitreal injections. Five cases were following Ranibizumab for ARMD, one case was following Ozurdex injection for macular oedema secondary to central retinal vein occlusion. One of the cases was a sterile. Negative vitreous and aqueous biopsy and had a very good recovery. Four cases showed isolates of coagulase negative Staphylococcus sp from vitreous biopsy. One of these patients had scanty amount of Bacillus species from enrichment culture from aqueous aspiration. Sixth case isolates showed two species of Streptococcus (Streptococcus mitis, Streptococcus sanguinis from vitreous tap and two species of Coagulase negative Staphylococcus sp from aqueous aspiration.
Our study also showed Coagulase negative Staphylococcus sp as the main isolates in post-intravitreal Endophthalmitis. Even though one case showed mixed growth of two species Streptococcus from vitreous tap but also demonstrated two species Coagulase negative Staphylococcus sp from aqueous aspiration. According to published data Coagulase negative Staphylococcus sp are the main conjunctival isolates. Our study showed have similar findings as Endophthalmitis Vitrectomy Study which islolated Coagulase-Negative Staphylococcus in 70% cases, Staphylococcus aureus 9.9%, Streptococcus Species 9.0%, Miscellaneous Gram-Positive Organisms 5.3%, Gram-Negative Species 5.9% following postoperative endophthalmitis.