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Endophthalmitis panorama in the Jerusalem area

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Abstract

Purpose

The spectrum of microbial infections and the pattern of their susceptibility are variable among communities. Researching these data will lead to the establishment of the most appropriate national management strategies. The purpose of this study was to analyze the epidemiological, clinical, microbial spectrum and antibiotic susceptibility of endophthalmitis cases in a tertiary referral center in Jerusalem.

Methods

Retrospective review of medical charts of patients presenting with endophthalmitis over a 12-year period.

Results

A total of 74 eyes of 70 patients (males 56%) were included. Mean age ± SD at presentation was 60 ± 19.5 years. Exogenous endophthalmitis accounted for 78% of cases, of which 62% followed an intraocular surgery, 21% occurred after intravitreal injections, 10% followed infectious keratitis and 7% were posttraumatic. Endogenous cases were predominantly observed in diabetic patients. Microbial isolates were identified in 44 samples. Of them, gram-positive bacteria were the predominant microorganisms detected in 33 samples (75%); Staphylococcus epidermidis and Enterococcus faecalis were the most commonly detected pathogens.

Mean presenting ± SD LogMAR visual acuity (VA) was 2.38 ± 1.21 and it improved at last follow-up to 1.7 ± 1.37 (p = 0.004, paired t test). Cases secondary to gram-positive microbes were associated with improved VA during the follow-up while cases secondary to gram-negative microbes was correlated with poor final VA (p = 0.046, r2 = 0.4). There was no evidence of bacterial resistance in the antibiograms for either vancomycin, ceftazidime, ceftriaxone or amikacin.

Conclusions

Intraocular surgery remains the most common event preceding endophthalmitis with coagulase-negative staphylococci being the most frequently detected microorganisms. The microbial spectrum of endophthalmitis is similar to that in the western world.

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Data availability

The corresponding author has full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis as well as the decision to submit for publication.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel

    Juan Martin Sanchez

  2. Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel

    Hila Elinav

  3. Department of Ophthalmology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, POB 12000, 91120, Jerusalem, Israel

    Liran Tiosano & Radgonde Amer

Authors
  1. Juan Martin Sanchez
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  2. Hila Elinav
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  3. Liran Tiosano
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  4. Radgonde Amer
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Contributions

All authors contributed to collection of data, analysis, writing and reviewing the manuscript.

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Correspondence to Radgonde Amer.

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The authors declare that they have no conflict of interest.

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The institutional review board of the hospital ((HMO-Hadassah Medical Organization IRB) approved the study, including waiver of informed consent for this chart review study. The study was conducted adhering to the tenets of the Declaration of Helsinki.

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Sanchez, J.M., Elinav, H., Tiosano, L. et al. Endophthalmitis panorama in the Jerusalem area. Int Ophthalmol 42, 1523–1535 (2022). https://doi.org/10.1007/s10792-021-02142-z

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  • DOI: https://doi.org/10.1007/s10792-021-02142-z

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