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D. Hammoudi, I. Ahmed, D.T. W. Wong; Is the Flora in Endophthalmitis Changing . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5565.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To identify trends in infectious endophthalmitis flora in the Greater Toronto Area (GTA). Methods: A retrospective chart review was conducted of 172 consecutive patients with positive culture results for infectious endophthalmitis at St Michael’s Hospital between January 1999 and July 2004. Outcome data 6–12 months post–presentation was collected from the patient’s ophthalmologist. Results:Overall 82% of cases were post–operative endophthalmitis, 5.8% cases were post–traumatic, 4.7% cases were endogenous and in 5.8 % of cases, the inciting factor was not available. At presentation, 51.1% of cases had hand motions or better vision, 30.2% of cases had light perception vision, 2.3% of cases presented with no light perception and in 9.9% of cases, presenting visual acuity was not available. For treatment, 35.5% of cases had tap and antibiotic injection, 33.1% of cases had vitrectomy, and 24.4% of cases had initial tap and antibiotic injection followed by vitrectomy. The causative agent was coagulase negative staphylococcus in 57.6% of cases, staphylococcus aureus in 5.8% of cases, streptococcus species in 20.9% of cases, other bacterial species in 13.9% of cases and fungal in 1.2% of cases. Culture results were unavailable in 0.5% of cases. The incidence of coagulase negative staphylococcus (CNS) had declined over the last three years from 58% to 46% of cases. Six to twelve months post–presentation, 33.1% of cases achieved visual outcome of 20/100 or better, 8.1% achieved 20/200 to 20/400, 15.7% achieved outcome between counting fingers and light perception and 12.8% had no light perception. Patients with species not–CNS infection were 9.4 times less likely to achieve 20/100 or better vision (P<0.001). Conclusions: Infection by flora other than CNS has been associated with poorer visual outcomes, and the prevelance of CNS has been declining over the last three years, and replaced by other possibly more aggressive flora.
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