Delayed-onset bleb-associated endophthalmitis: presentation and outcome by culture result

David J Jacobs, Theodore Leng, Harry W Flynn Jr, Wei Shi, Darlene Miller, Steven J GeddeDepartment of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, FL, USAPurpose: To determine how culture results are associated with clinical presentations and outcomes i...

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Auteurs principaux:	Jacobs DJ, Leng T, Flynn HW Jr, Shi W, Miller D, Gedde SJ
Format:	article
Langue:	EN
Publié:	Dove Medical Press 2011
Sujets:	Ophthalmology RE1-994
Accès en ligne:	https://doaj.org/article/a112380b72844917baa9bc61c1b51a5a
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spelling	oai:doaj.org-article:a112380b72844917baa9bc61c1b51a5a2021-12-02T07:43:11ZDelayed-onset bleb-associated endophthalmitis: presentation and outcome by culture result1177-54671177-5483https://doaj.org/article/a112380b72844917baa9bc61c1b51a5a2011-06-01T00:00:00Zhttp://www.dovepress.com/delayed-onset-bleb-associated-endophthalmitis-presentation-and-outcome-a7587https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483David J Jacobs, Theodore Leng, Harry W Flynn Jr, Wei Shi, Darlene Miller, Steven J GeddeDepartment of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, FL, USAPurpose: To determine how culture results are associated with clinical presentations and outcomes in delayed-onset bleb-associated endophthalmitis (BAE).Methods: Retrospective consecutive case series of BAE at Bascom Palmer Eye Institute between January 1, 1996 and December 31, 2009. All patients had prior glaucoma filtering surgery. BAE was defined as intraocular infection with vitreous involvement receiving treatment with intravitreal antibiotics. Visual acuity (VA) outcomes and other clinical data were grouped by culture result and compared using the 2-sided Student&#39;s t-test.Main outcome measure: Mean logMAR change at 3 months after treatment (3-month logMAR&Delta;).Results: Eighty-six eyes of 85 patients were identified. Two eyes were primarily eviscerated. Fifty-three (63%) eyes were culture-positive with the following organisms: Streptococcus, 21 (25%); coagulase-negative Staphylococcus, 9 (11%); Enterococcus, 6 (7%); Gram-negative, 15 (18%); Moraxella, 8 (10%); Pseudomonas, 3 (4%); and Serratia, 3 (4%). Presenting logMAR VA: culture-positive worse than culture-negative cases (2.45 vs 2.19, P = 0.05). Presenting intraocular pressure (IOP): culture-positive higher than culture-negative cases (24 mmHg vs 14 mmHg, P = 0.002). Poor presenting view of the fundus: Streptococcus worse than coagulase-negative Staphylococcus cases (90% vs 44%, P = 0.006), Pseudomonas and Serratia worse than Moraxella cases (100% vs 50%, P = 0.04). Three month logMAR&Delta;: culture-positive worse than culture-negative cases (1.03 vs 0.43, P = 0.02), Streptococcus worse than coagulase-negative Staphylococcus cases (1.44 vs 0.31, P = 0.004), Pseudomonas and Serratia worse than coagulase-negative Staphylococcus cases (2.41 vs 0.31, P = 0.001), Pseudomonas and Serratia worse than Moraxella cases (2.41 vs 0.04, P = 0.001). A culture result of Streptococcus or Serratia was present in 6 of 7 eyes that received an additional treatment of enucleation or evisceration (P = 0.01).Conclusion: Culture-positive cases were associated with worse presenting VA, higher presenting IOP, and worse VA outcomes than culture-negative cases. Streptococcus, Pseudomonas, and Serratia cases were associated with poor presenting view of the fundus and worse VA outcomes than coagulase-negative Staphylococcus and Moraxella cases.Keywords: endophthalmitis, bleb-associated endophthalmitis, trabeculectomy, culture resultsJacobs DJLeng TFlynn HW JrShi WMiller DGedde SJDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2011, Iss default, Pp 739-744 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Jacobs DJ Leng T Flynn HW Jr Shi W Miller D Gedde SJ Delayed-onset bleb-associated endophthalmitis: presentation and outcome by culture result
description	David J Jacobs, Theodore Leng, Harry W Flynn Jr, Wei Shi, Darlene Miller, Steven J GeddeDepartment of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, FL, USAPurpose: To determine how culture results are associated with clinical presentations and outcomes in delayed-onset bleb-associated endophthalmitis (BAE).Methods: Retrospective consecutive case series of BAE at Bascom Palmer Eye Institute between January 1, 1996 and December 31, 2009. All patients had prior glaucoma filtering surgery. BAE was defined as intraocular infection with vitreous involvement receiving treatment with intravitreal antibiotics. Visual acuity (VA) outcomes and other clinical data were grouped by culture result and compared using the 2-sided Student&#39;s t-test.Main outcome measure: Mean logMAR change at 3 months after treatment (3-month logMAR&Delta;).Results: Eighty-six eyes of 85 patients were identified. Two eyes were primarily eviscerated. Fifty-three (63%) eyes were culture-positive with the following organisms: Streptococcus, 21 (25%); coagulase-negative Staphylococcus, 9 (11%); Enterococcus, 6 (7%); Gram-negative, 15 (18%); Moraxella, 8 (10%); Pseudomonas, 3 (4%); and Serratia, 3 (4%). Presenting logMAR VA: culture-positive worse than culture-negative cases (2.45 vs 2.19, P = 0.05). Presenting intraocular pressure (IOP): culture-positive higher than culture-negative cases (24 mmHg vs 14 mmHg, P = 0.002). Poor presenting view of the fundus: Streptococcus worse than coagulase-negative Staphylococcus cases (90% vs 44%, P = 0.006), Pseudomonas and Serratia worse than Moraxella cases (100% vs 50%, P = 0.04). Three month logMAR&Delta;: culture-positive worse than culture-negative cases (1.03 vs 0.43, P = 0.02), Streptococcus worse than coagulase-negative Staphylococcus cases (1.44 vs 0.31, P = 0.004), Pseudomonas and Serratia worse than coagulase-negative Staphylococcus cases (2.41 vs 0.31, P = 0.001), Pseudomonas and Serratia worse than Moraxella cases (2.41 vs 0.04, P = 0.001). A culture result of Streptococcus or Serratia was present in 6 of 7 eyes that received an additional treatment of enucleation or evisceration (P = 0.01).Conclusion: Culture-positive cases were associated with worse presenting VA, higher presenting IOP, and worse VA outcomes than culture-negative cases. Streptococcus, Pseudomonas, and Serratia cases were associated with poor presenting view of the fundus and worse VA outcomes than coagulase-negative Staphylococcus and Moraxella cases.Keywords: endophthalmitis, bleb-associated endophthalmitis, trabeculectomy, culture results
format	article
author	Jacobs DJ Leng T Flynn HW Jr Shi W Miller D Gedde SJ
author_facet	Jacobs DJ Leng T Flynn HW Jr Shi W Miller D Gedde SJ
author_sort	Jacobs DJ
title	Delayed-onset bleb-associated endophthalmitis: presentation and outcome by culture result
title_short	Delayed-onset bleb-associated endophthalmitis: presentation and outcome by culture result
title_full	Delayed-onset bleb-associated endophthalmitis: presentation and outcome by culture result
title_fullStr	Delayed-onset bleb-associated endophthalmitis: presentation and outcome by culture result
title_full_unstemmed	Delayed-onset bleb-associated endophthalmitis: presentation and outcome by culture result
title_sort	delayed-onset bleb-associated endophthalmitis: presentation and outcome by culture result
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/a112380b72844917baa9bc61c1b51a5a
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Delayed-onset bleb-associated endophthalmitis: presentation and outcome by culture result

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