Ikram Hussain1, Saba Ishrat2, Dawn Ching Wen Ho3, Shahab R Khan4, Meyyur Aravamudan Veeraraghavan5, Bharath Raj Palraj6, James S Molton7, Muhammad Bilal Abid8. 1. Division of Gastroenterology, Department of Medicine, Woodlands Health Campus, Singapore, Singapore. Electronic address: ikram_hussain@whc.sg. 2. Singapore National Eye Centre, Singapore, Singapore. 3. Department of Ophthalmology, National Healthcare Group Eye Institute, Singapore, Singapore. 4. Section of Gastroenterology, Rush University Medical Center, Chicago, IL, USA. 5. Department of Medicine, Woodlands Health Campus, Singapore, Singapore. 6. Division of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN, USA. 7. Western Health, Footscray, Victoria, Australia. 8. Divisions of Infectious Diseases & Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: mabid@mcw.edu.
Abstract
BACKGROUND: Endogenous endophthalmitis (EE) is a devastating complication that develops as a metastatic infection in patients with Klebsiella pneumoniae pyogenic liver abscess (KPPLA). The existing data are heterogeneous and the actual disease burden and risk factors for the development of EE among patients with KPPLA have not been systematically examined. We performed a systematic review and meta-analysis to examine the incidence of EE, temporal trend of EE, and risk factors for EE in patients with KPPLA. METHODOLOGY: The MEDLINE, EMBASE, Web of Science, and Cochrane Library databases were searched for articles published from inception to 2020 that evaluated the incidence of EE among patients with KPPLA. By a random-effects method, a pooled estimate of its incidence with 95% confidence intervals was estimated along with examination of its temporal and geographic variations. Pooled odds ratios were calculated for risk factors. RESULTS: Fifteen retrospective studies reporting data on 11889 patients with KPPLA met the inclusion criteria and were analyzed. With 217 patients developing EE, the pooled incidence of EE was 4.5% (95% confidence interval 2.4% to 8.2%). The heterogeneity was considerable and significant (Cochran's Q 243.5, p < 0.001, I2 = 94.2%). CONCLUSION: This meta-analysis estimates the actual incidence of EE among patients with KPPLA, where EE is reported in about 1 of 22 patients with KPPLA. Infection caused by K1 capsular serotype was an independent risk factor.
BACKGROUND: Endogenous endophthalmitis (EE) is a devastating complication that develops as a metastatic infection in patients with Klebsiella pneumoniae pyogenic liver abscess (KPPLA). The existing data are heterogeneous and the actual disease burden and risk factors for the development of EE among patients with KPPLA have not been systematically examined. We performed a systematic review and meta-analysis to examine the incidence of EE, temporal trend of EE, and risk factors for EE in patients with KPPLA. METHODOLOGY: The MEDLINE, EMBASE, Web of Science, and Cochrane Library databases were searched for articles published from inception to 2020 that evaluated the incidence of EE among patients with KPPLA. By a random-effects method, a pooled estimate of its incidence with 95% confidence intervals was estimated along with examination of its temporal and geographic variations. Pooled odds ratios were calculated for risk factors. RESULTS: Fifteen retrospective studies reporting data on 11889 patients with KPPLA met the inclusion criteria and were analyzed. With 217 patients developing EE, the pooled incidence of EE was 4.5% (95% confidence interval 2.4% to 8.2%). The heterogeneity was considerable and significant (Cochran's Q 243.5, p < 0.001, I2 = 94.2%). CONCLUSION: This meta-analysis estimates the actual incidence of EE among patients with KPPLA, where EE is reported in about 1 of 22 patients with KPPLA. Infection caused by K1 capsular serotype was an independent risk factor.
Authors: Maria A De Francesco; Giorgio Tiecco; Erika Scaltriti; Giorgio Piccinelli; Silvia Corbellini; Francesca Gurrieri; Verena Crosato; Giovanni Moioli; Valentina Marchese; Emanuele Focà; Davide A Bertelli; Francesco Castelli; Arnaldo Caruso Journal: Infection Date: 2022-07-08 Impact factor: 3.553
Authors: Edwin Kamau; Paul R Allyn; Omer E Beaird; Kevin W Ward; Nancy Kwan; Omai B Garner; Shangxin Yang Journal: Emerg Infect Dis Date: 2021 Impact factor: 6.883