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Comparison of clinico-microbiological profile and treatment outcome of in-house and referred post cataract surgery endophthalmitis in a tertiary care center in South India

View Article: PubMed Central - PubMed

ABSTRACT

Background: The purpose of the study is to compare the clinico-microbiological profile and treatment outcome of in-house vs referred cases of post cataract surgery endophthalmitis in a tertiary eye care facility in South India.

Methods: The clinical records of 50 culture-positive cases each of in-house (group A) and referred (group B) post cataract surgery endophthalmitis were analyzed. The management protocol was similar in both groups.

Results: The time to report to the institute was longer in group B (group B 13.63 [±11.67; 95% CI, 9.95–17.31] days; group A 6.83 [±7.61; 95% CI, 4.57–9.09] days; P = 0.002). The average inflammatory scores in presentation were comparable (group A 17.85 ± 5.83; group B 18.18 ± 7.35; P = 0.243). The final visual outcome was clinically superior in group A (≥20/200-group A 60.42% and group B 44%, P = 0.11; ≤20/400-group A 37.5% and group B 52%, P = 0.62), but statistically not significant. There were more gram-positive organisms in group A (62% vs 38%; P = 0.027) and more gram-negative organisms in group B (52% vs 24%; P = 0.007). Gram-positive bacteria were mostly sensitive to vancomycin (95.24% to 96.67%), but gram-negative bacteria were partly sensitive to ceftazidime (58.33% to 64%).

Conclusions: One could suspect gram-negative infection more often in the referred cases of endophthalmitis. While vancomycin could continue to be the antibiotic of choice in gram-positive bacteria, specific antibiotic following due sensitivity for gram-negative bacteria should replace the empiric use of ceftazidime.

No MeSH data available.


Antibiotic sensitivity profile of gram-negative isolates in groups A and B, showing percentage sensitivity with 95% CI
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Fig2: Antibiotic sensitivity profile of gram-negative isolates in groups A and B, showing percentage sensitivity with 95% CI

Mentions: The sensitivity profile of the bacteria in the two groups is shown in Figs. 1 and 2. More than 95% gram-positive isolates in both groups (96.67% in group A, 95.24% in group B; P = 1) were sensitive to vancomycin and between 85% and 90% (90.32% gram-positive isolates in group A, and in 85.71% in group B) were sensitive to cefazolin. Only 58.33% of gram-negative isolates in group A and 64% gram-negative isolates in group B were sensitive to ceftazidime. The sensitivity of amikacin compared to ceftazidime in both groups (group A: amikacin 80% vs ceftazidime 58.33% sensitive, P = 0.22; group B: amikacin 73.06% vs ceftazidime 64% sensitive, P = 0.56) was not statistically significant.Fig. 1


Comparison of clinico-microbiological profile and treatment outcome of in-house and referred post cataract surgery endophthalmitis in a tertiary care center in South India
Antibiotic sensitivity profile of gram-negative isolates in groups A and B, showing percentage sensitivity with 95% CI
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121114&req=5

Fig2: Antibiotic sensitivity profile of gram-negative isolates in groups A and B, showing percentage sensitivity with 95% CI
Mentions: The sensitivity profile of the bacteria in the two groups is shown in Figs. 1 and 2. More than 95% gram-positive isolates in both groups (96.67% in group A, 95.24% in group B; P = 1) were sensitive to vancomycin and between 85% and 90% (90.32% gram-positive isolates in group A, and in 85.71% in group B) were sensitive to cefazolin. Only 58.33% of gram-negative isolates in group A and 64% gram-negative isolates in group B were sensitive to ceftazidime. The sensitivity of amikacin compared to ceftazidime in both groups (group A: amikacin 80% vs ceftazidime 58.33% sensitive, P = 0.22; group B: amikacin 73.06% vs ceftazidime 64% sensitive, P = 0.56) was not statistically significant.Fig. 1

View Article: PubMed Central - PubMed

ABSTRACT

Background: The purpose of the study is to compare the clinico-microbiological profile and treatment outcome of in-house vs referred cases of post cataract surgery endophthalmitis in a tertiary eye care facility in South India.

Methods: The clinical records of 50 culture-positive cases each of in-house (group A) and referred (group B) post cataract surgery endophthalmitis were analyzed. The management protocol was similar in both groups.

Results: The time to report to the institute was longer in group B (group B 13.63 [±11.67; 95% CI, 9.95–17.31] days; group A 6.83 [±7.61; 95% CI, 4.57–9.09] days; P = 0.002). The average inflammatory scores in presentation were comparable (group A 17.85 ± 5.83; group B 18.18 ± 7.35; P = 0.243). The final visual outcome was clinically superior in group A (≥20/200-group A 60.42% and group B 44%, P = 0.11; ≤20/400-group A 37.5% and group B 52%, P = 0.62), but statistically not significant. There were more gram-positive organisms in group A (62% vs 38%; P = 0.027) and more gram-negative organisms in group B (52% vs 24%; P = 0.007). Gram-positive bacteria were mostly sensitive to vancomycin (95.24% to 96.67%), but gram-negative bacteria were partly sensitive to ceftazidime (58.33% to 64%).

Conclusions: One could suspect gram-negative infection more often in the referred cases of endophthalmitis. While vancomycin could continue to be the antibiotic of choice in gram-positive bacteria, specific antibiotic following due sensitivity for gram-negative bacteria should replace the empiric use of ceftazidime.

No MeSH data available.