Purpose

The spectrum of microbial infections and the pattern of their susceptibility are variable among communities. Researching these data will lead to the establishment of the most appropriate national management strategies. The purpose of this study was to analyze the epidemiological, clinical, microbial spectrum and antibiotic susceptibility of endophthalmitis cases in a tertiary referral center in Jerusalem.

Methods

Retrospective review of medical charts of patients presenting with endophthalmitis over a 12-year period.

Results

A total of 74 eyes of 70 patients (males 56%) were included. Mean age ± SD at presentation was 60 ± 19.5 years. Exogenous endophthalmitis accounted for 78% of cases, of which 62% followed an intraocular surgery, 21% occurred after intravitreal injections, 10% followed infectious keratitis and 7% were posttraumatic. Endogenous cases were predominantly observed in diabetic patients. Microbial isolates were identified in 44 samples. Of them, gram-positive bacteria were the predominant microorganisms detected in 33 samples (75%); Staphylococcus epidermidis and Enterococcus faecalis were the most commonly detected pathogens.

Mean presenting ± SD LogMAR visual acuity (VA) was 2.38 ± 1.21 and it improved at last follow-up to 1.7 ± 1.37 (p = 0.004, paired t test). Cases secondary to gram-positive microbes were associated with improved VA during the follow-up while cases secondary to gram-negative microbes was correlated with poor final VA (p = 0.046, r² = 0.4). There was no evidence of bacterial resistance in the antibiograms for either vancomycin, ceftazidime, ceftriaxone or amikacin.

Conclusions

Intraocular surgery remains the most common event preceding endophthalmitis with coagulase-negative staphylococci being the most frequently detected microorganisms. The microbial spectrum of endophthalmitis is similar to that in the western world.

中文翻译：

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耶路撒冷地区的眼内炎全景

目的

微生物感染的范围及其易感性模式在社区之间是不同的。研究这些数据将导致制定最合适的国家管理战略。本研究的目的是分析耶路撒冷三级转诊中心眼内炎病例的流行病学、临床、微生物谱和抗生素敏感性。

方法

回顾性回顾 12 年来眼内炎患者的病历。

结果

共纳入 70 名患者（男性 56%）的 74 只眼。就诊时的平均年龄 ± SD 为 60 ± 19.5 岁。外源性眼内炎占78%，其中62%发生在眼内手术后，21%发生在玻璃体内注射后，10%发生在感染性角膜炎后，7%发生在外伤后。内源性病例主要在糖尿病患者中观察到。在 44 个样品中鉴定出微生物分离物。其中，革兰氏阳性菌是 33 个样本（75%）中检出的主要微生物；表皮葡萄球菌和粪肠球菌是最常检测到的病原体。

平均呈现 ± SD LogMAR 视力 (VA) 为 2.38 ± 1.21，在最后一次随访时改善至 1.7 ± 1.37 ( p  = 0.004，配对t检验)。继发于革兰氏阳性微生物的病例与随访期间改善的 VA 相关，而继发于革兰氏阴性微生物的病例与较差的最终 VA 相关（p  = 0.046，r ²  = 0.4）。万古霉素、头孢他啶、头孢曲松或阿米卡星的抗菌谱中均未发现细菌耐药性的证据。

结论

眼内手术仍然是眼内炎之前最常见的事件，其中凝固酶阴性葡萄球菌是最常检测到的微生物。眼内炎的微生物谱与西方世界相似。