Postoperative endophthalmitis is a rare but dreaded complication of intraocular surgery and often results in severe visual impairment or blindness. The present study describes the clinical course, treatment and visual outcome of an outbreak of Burkholderia contaminans endophthalmitis following cataract surgery. Among 290 patients who underwent uneventful phacoemulsification cataract surgery at one outpatient clinic between January 4th and 28th 2019, 6 cases developed Burkholderia contaminans endophthalmitis. Clinical data were collected by retrospective review of patient records. Microbiological samples from vitreous aspirates, intraocular lenses (IOL) and lens capsules were cultured, and recA and draft whole genome sequences analysed. The recA sequences of all Burkholderia contaminans isolates and the allelic profile of the isolates were identical. All cases had a similar clinical presentation with rapid development of endophthalmitis symptoms with variable time to onset. The mean time to admission was 34 days (12–112 days). All cases had a seemingly favourable response to intravitreal antibiotics. However, acute recurrences occurred after long time periods (12–71 days). The cases experienced between 0 and 3 recurrences. Due to persistent infection, the cases received between 5 and 15 treatments (mean 7.8) including IOL and lens capsule explantation in 5 of 6 cases. Burkholderia contaminans was detected in all explanted lens capsules. The final corrected distance visual acuity (CDVA, Snellen chart) was between 0.8 and 1.2 and all cases had final CDVA ≥0.8. A persistent and intensive treatment approach including total lens capsule and IOL explantation is recommended for Burkholderia contaminans endophthalmitis following cataract surgery and may lead to a favourable visual result.

中文翻译：

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白内障手术后感染伯克霍尔德氏菌感染眼内炎的临床过程，治疗和视觉结果

术后眼内炎是眼内手术罕见但可怕的并发症，通常会导致严重的视力障碍或失明。本研究描述了白内障手术后感染伯克霍尔德氏菌眼内炎的临床过程，治疗方法和视觉效果。在2019年1月4日至28日期间，在一家门诊接受过无创超声乳化白内障手术的290例患者中，有6例发展为感染伯克霍尔德氏菌眼内炎。通过回顾性记录患者的病历来收集临床数据。培养了玻璃体抽吸物，人工晶状体（IOL）和晶状体囊的微生物样本，并分析了recA和拟定全基因组序列。所有伯克霍尔德氏菌污染分离株的recA序列和分离株的等位基因谱是相同的。所有病例均具有相似的临床表现，但眼内炎症状迅速发展且发病时间不同。入院的平均时间为34天（12-112天）。所有病例对玻璃体内抗生素的反应看似良好。但是，长时间（12-71天）后会发生急性复发。病例复发0到3次。由于持续感染，在6例中有5例接受了5到15种治疗（平均7.8），包括IOL和晶状体囊外植。在所有移出的晶状体囊中均检出伯克霍尔德氏菌。最终的矫正远视力（CDVA，Snellen图表）在0.8到1.2之间，所有病例的最终CDVA≥0.8。