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Michael Dollin, Philip Storey, John Pitcher, James Vander, Jason Hsu, Sunir Garg; Microbial spectrum of endophthalmitis following intravitreal injection versus pars plana vitrectomy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):6310.
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To compare causative organisms in endophthalmitis following intravitreal injection (IVI) to endophthalmitis following pars plana vitrectomy (PPV).
Retrospective review of all available bacterial cultures in patients who developed endophthalmitis following IVI or PPV between January 1, 2009, and October 1, 2012, from one large vitreoretinal practice. Data were analyzed using Fisher’s exact test (two-tailed).
Bacterial cultures from 34 cases of endophthalmitis following IVI, and 17 cases of endophthalmitis following PPV, were reviewed. In the IVI group, 14 cases (41.2%) were culture positive. Seven of these cases showed growth of bacteria associated with oral flora: Streptococcus viridans, Streptococcus mitis, Streptococcus salivarius, Streptococcus sanguinis, Enterococcus faecalis (2 cases), and Lactobacillus. In the PPV group, 8 cases (47.1%) were culture positive. The most common organisms in this group were Staph species, and none of the cultures grew bacteria associated with oral flora. Patients who developed endophthalmitis after IVI were significantly more likely than patients developing endophthalmitis after PPV to grow bacteria associated with oral flora (P = 0.023).
Endophthalmitis following IVI has a higher likelihood of being due to oral flora compared to endophthalmitis following PPV. Caution should be taken to avoid introduction of oral flora onto the eye during IVI.
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