PURPOSE: To assess the frequency of persistent infection after injection of intravitreal antimicrobials as therapy for endophthalmitis and to determine if persistent infection influences the final visual outcome after treatment. METHODS: In a series of 42 eyes with culture-positive endophthalmitis of various types, the authors performed a second vitreous culture and injection of antimicrobial agents in 22 eyes. Repeat cultures were obtained 3 to 8 days after initial therapy in 20 of the 22 eyes. RESULTS: Twelve of the 22 eyes were persistently culture-positive. Organisms identified in the persistently culture-positive eyes included staphylococcal species (n = 4), Streptococcus (n = 4), Serratia (n = 1), Propionibacterium acnes (n = 1), and fungi (n = 2). Eyes in which the initial antimicrobial therapy failed to eradicate a bacterial infection had a worse outcome than those that were culture-negative on repeat sampling. Final visual acuity of 20/200 or better after repeat injection was attained in 4 of the 12 culture-positive eyes. CONCLUSION: A single injection of intravitreal antimicrobial agents may be insufficient to cure some cases of endophthalmitis, and a second injection should be considered in some circumstances.
PURPOSE: To assess the frequency of persistent infection after injection of intravitreal antimicrobials as therapy for endophthalmitis and to determine if persistent infection influences the final visual outcome after treatment. METHODS: In a series of 42 eyes with culture-positive endophthalmitis of various types, the authors performed a second vitreous culture and injection of antimicrobial agents in 22 eyes. Repeat cultures were obtained 3 to 8 days after initial therapy in 20 of the 22 eyes. RESULTS: Twelve of the 22 eyes were persistently culture-positive. Organisms identified in the persistently culture-positive eyes included staphylococcal species (n = 4), Streptococcus (n = 4), Serratia (n = 1), Propionibacterium acnes (n = 1), and fungi (n = 2). Eyes in which the initial antimicrobial therapy failed to eradicate a bacterial infection had a worse outcome than those that were culture-negative on repeat sampling. Final visual acuity of 20/200 or better after repeat injection was attained in 4 of the 12 culture-positive eyes. CONCLUSION: A single injection of intravitreal antimicrobial agents may be insufficient to cure some cases of endophthalmitis, and a second injection should be considered in some circumstances.
Authors: Ajay E Kuriyan; Jayanth Sridhar; Harry W Flynn; William E Smiddy; Thomas A Albini; Audina M Berrocal; Richard K Forster; Peter J Belin; Darlene Miller Journal: Am J Ophthalmol Date: 2014-08-01 Impact factor: 5.258
Authors: C Chiquet; A Pechinot; C Creuzot-Garcher; Y Benito; J Croize; S Boisset; J P Romanet; G Lina; F Vandenesch Journal: J Clin Microbiol Date: 2007-03-28 Impact factor: 5.948
Authors: Michael Engelbert; Herminia Miño de Kaspar; Martina Mette; Martin Thiel; Christopher N Ta; Thomas Grasbon; Markus Schulze-Schwering; Volker Klauss; Anselm Kampik Journal: Graefes Arch Clin Exp Ophthalmol Date: 2003-11-14 Impact factor: 3.117
Authors: E Brillat-Zaratzian; A Bron; F Aptel; J P Romanet; P L Cornut; F Vandenesch; S Boisset; M Maurin; C Chiquet Journal: Graefes Arch Clin Exp Ophthalmol Date: 2013-11-19 Impact factor: 3.117