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Ella H Leung, Ajay E Kuriyan, Harry W Flynn, Laura C Huang, Darlene Miller; Microbiological Isolates in Persistently Culture Positive Endophthalmitis . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):277.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the incidence of persistent endophthalmitis, to identify the most common microorganisms that are present after initial treatment with intravitreal antibiotics, and to compare the infectious etiologies in repeat positive vitreous cultures.
Non-comparative case series of patients with positive vitreous cultures obtained at the Bascom Palmer Eye Institute from 1981-2011.
Out of 1,079 patients with positive vitreous cultures, there were 76 patients (7.05%) who continued to have signs and symptoms of endophthalmitis and had repeat intraocular cultures that were still positive after one injection of intravitreal antibiotics. Gram positive bacteria were identified in 48.6% of patients (n=37), gram negative bacteria in 9.21% (n=7), polymicrobial in 19.2% (n=15), and<br /> fungi in 15.8% (n=12). Thirteen percent (9 of 76 patients) had a mixture of fungi and bacteria, and 15% (11 of 76 patients) had a different organism identified on subsequent cultures. The most commonly identified organisms in persistent endophthalmitis were Staphylococcus species (39.5%, n=30), Streptococcus species (26.3%, n=20), Enterococcus species (13.2%, n=10), Candida species (7.89%, n=6), Propionibacterium species (7.89%, n=6), Pseudomonas species (6.57%, n=5), Aspergillus species (5.26%, n=4), and Acremonium species (3.95%, n=3).
Persistently culture endophthalmitis is uncommon but not rare. Overall, gram positive bacteria were the most commonly identified organism. Specifically, Staphylococcus species and Streptococcus species remained the most common infectious etiologies.
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