Skip to main content

Advertisement

SpringerLink
Log in

FRIENDS Group: clinical and microbiological characteristics of post-filtering surgery endophthalmitis

  • Glaucoma
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To study the clinical and microbiological characteristics as well as the prognostic factors for post-filtering surgery endophthalmitis.

Methods

Twenty-three eyes were included in the study in four tertiary centres between 2004 and 2010. The clinical and microbiological data were collected prospectively (minimum follow-up, 6 months). Microbiological diagnosis was based on conventional cultures and panbacterial PCR (16SrDNA amplification and sequencing).

Results

The onset of endophthalmitis was early (<6 weeks) in 22 % of the cases and delayed in 78 %. Elevated intraocular pressure and hypopyon were more frequent in delayed than in early presentations (p = 0.04). By combining the results of culture and panbacterial PCR, a bacterial species could be identified in 73.9 % of the cases, including 56.5 % of commensal species of the digestive tract such as Moraxella spp., oropharyngeal streptococci and Enterococcus faecalis. Good final visual acuity (VA ≥ 20/40) was correlated with initial VA greater than light perception (p = 0.05). Poor final VA (≤20/400) was correlated with a higher virulence of the infecting bacterial species (p = 0.006), and was noted in all patients with early-onset endophthalmitis.

Conclusion

Acute early- or delayed-onset post-filtering surgery endophthalmitis is frequently caused by bacteria of the digestive tract (e.g., Streptococcus and Enterococcus spp.). The combination of conventional cultures and panbacterial PCR allowed us to identify the causative microorganism in three-quarters of the cases, i.e., 21 % more cases than through culture alone. Despite adequate antibiotic and surgical treatment, the anatomical and visual prognosis remains poor.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Edmunds B, Thompson JR, Salmon JF, Wordmald RP (2002) The National Survey of Trabeculectomy. III. Early and late complications. Eye 16:297–303

    Article  CAS  PubMed  Google Scholar 

  2. DeBry PW, Perkins TW, Heatley G, Kaufman P, Brumback LC (2002) Incidence of late-onset bleb-related complications following trabeculectomy with mitomycin. Arch Ophthalmol 120:297–300

    Article  CAS  PubMed  Google Scholar 

  3. Song A, Scott IU, Flynn HW Jr, Budenz DL (2002) Delayed-onset bleb-associated endophthalmitis: clinical features and visual acuity outcomes. Ophthalmology 109:985–991

    Article  PubMed  Google Scholar 

  4. Lehmann OJ, Bunce C, Matheson MM, Maurino V, Khaw PT, Wormald R, Barton K (2000) Risk factors for development of post-trabeculectomy endophthalmitis. Br J Ophthalmol 84:1349–1353

    Article  CAS  PubMed  Google Scholar 

  5. Rai P, Kotecha A, Kaltsos K, Ruddle JB, Murdoch IE, Bunce C, Barton K (2012) Changing trends in the incidence of bleb-related infection in trabeculectomy. Br J Ophthalmol 96:971–975

    Article  PubMed  Google Scholar 

  6. Busbee BG, Recchia FM, Kaiser R, Nagra P, Rosenblatt B, Pearlman RB (2004) Bleb-associated endophthalmitis: clinical characteristics and visual outcomes. Ophthalmology 111:1495–1503, discussion 1503

    Article  PubMed  Google Scholar 

  7. Ciulla TA, Beck AD, Topping TM, Baker AS (1997) Blebitis, early endophthalmitis, and late endophthalmitis after glaucoma-filtering surgery. Ophthalmology 104:986–995

    Article  CAS  PubMed  Google Scholar 

  8. Leng T, Miller D, Flynn HW Jr, Jacobs DJ, Gedde SJ (2011) Delayed-onset bleb-associated endophthalmitis (1996–2008): causative organisms and visual acuity outcomes. Retina 31:344–352

    Article  PubMed  Google Scholar 

  9. Sharan S, Trope GE, Chipman M, Buys YM (2009) Late-onset bleb infections: prevalence and risk factors. Can J Ophthalmol 44:279–283

    Article  PubMed  Google Scholar 

  10. Waheed S, Ritterband DC, Greenfield DS, Liebmann JM, Seedor JA, Ritch R (1998) New patterns of infecting organisms in late bleb-related endophthalmitis: a ten year review. Eye 12:910–915

    Article  PubMed  Google Scholar 

  11. Chiquet C, Cornut PL, Benito Y, Thuret G, Maurin M, Lafontaine PO, Pechinot A, Palombi K, Lina G, Bron A, Denis P, Carricajo A, Creuzot C, Romanet JP, Vandenesch F (2008) Eubacterial PCR for bacterial detection and identification in 100 acute postcataract surgery endophthalmitis. Invest Ophthalmol Vis Sci 49:1971–1978

    Article  PubMed  Google Scholar 

  12. Cornut PL, Chiquet C, Bron A, Romanet JP, Lina G, Lafontaine PO, Benito Y, Pechinot A, Burillon C, Vandenesch F, Denis P (2008) Microbiologic identification of bleb-related delayed-onset endophthalmitis caused by moraxella species. J Glaucoma 17:541–545

    Article  PubMed  Google Scholar 

  13. Altuntas F, Yldiz O, Eser B, Gundogan K, Sumerkan B, Cetin M (2004) Catheter-related bacteremia due to Kocuria rosea in a patient undergoing peripheral blood stem cell transplantation. BMC Infect Dis 4:62

    Article  PubMed Central  PubMed  Google Scholar 

  14. Ang GS, Varga Z, Shaarawy T (2010) Postoperative infection in penetrating versus non-penetrating glaucoma surgery. Br J Ophthalmol 94:1571–1576

    Article  PubMed  Google Scholar 

  15. Chiselita D, Cantemir A, Ilies I (2010) Non-penetrating deep sclerectomy–between safety and efficacy. Oftalmologia 54:77–83

    CAS  PubMed  Google Scholar 

  16. Higginbotham EJ, Stevens RK, Musch DC, Karp KO, Lichter PR, Bergstrom TJ, Skuta GL (1996) Bleb-related endophthalmitis after trabeculectomy with mitomycin C. Ophthalmology 103:650–656

    Article  CAS  PubMed  Google Scholar 

  17. Jampel HD, Quigley HA, Kerrigan-Baumrind LA, Melia BM, Friedman D, Barron Y (2001) Risk factors for late-onset infection following glaucoma filtration surgery. Arch Ophthalmol 119:1001–1008

    Article  CAS  PubMed  Google Scholar 

  18. Laukeland H, Bergh K, Bevanger L (2002) Posttrabeculectomy endophthalmitis caused by Moraxella nonliquefaciens. J Clin Microbiol 40:2668–2770

    PubMed Central  PubMed  Google Scholar 

  19. Tang CW, Cheng CK, Lee TS (2007) Community-acquired bleb-related endophthalmitis caused by vancomycin-resistant enterococci. Can J Ophthalmol 42:477–478

    Article  PubMed  Google Scholar 

  20. Scott IU, Loo RH, Flynn HW Jr, Miller D (2003) Endophthalmitis caused by enterococcus faecalis: antibiotic selection and treatment outcomes. Ophthalmology 110:1573–1577

    Article  PubMed  Google Scholar 

  21. Gomez-Garces JL, Oteo J, Garcia G, Aracil B, Alos JI, Funke G (2001) Bacteremia by Dermabacter hominis, a rare pathogen. J Clin Microbiol 39:2356–2357

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Shaarawy A, Grand MG, Meredith TA, Ibanez HE (1995) Persistent endophthalmitis after intravitreal antimicrobial therapy. Ophthalmology 102:382–387

    Article  CAS  PubMed  Google Scholar 

  23. Almanjoumi AM, Combey A, Romanet JP, Chiquet C (2012) 23-gauge transconjunctival sutureless vitrectomy in treatment of post-operative endophthalmitis. Graefes Arch Clin Exp Ophthalmol 250:1367–1371

    Article  PubMed  Google Scholar 

  24. Kanski JJ (1974) Treatment of late endophthalmitis associated with filtering blebs. Arch Ophthalmol 91:339–343

    Article  CAS  PubMed  Google Scholar 

  25. Katz LJ, Cantor LB, Spaeth GB (1985) Complications of surgery in glaucoma. Early and late bacterial endophthalmitis following glaucoma filtering surgery. Ophthalmology 92:959–963

    Article  CAS  PubMed  Google Scholar 

  26. Yaldo MK, Stamper RL (1993) Long-term effects of mitomycin on filtering blebs. Lack of fibrovascular proliferative response following severe inflammation. Arch Ophthalmol 111:824–826

    Article  CAS  PubMed  Google Scholar 

  27. Schmier JK, Covert DW, Lau EC, Robin AL (2009) Trends in annual medicare expenditures for glaucoma surgical procedures from 1997 to 2006. Arch Ophthalmol 127:900–905

    Article  PubMed  Google Scholar 

Download references

Grants

This study was supported by grants from Thea Laboratories and the Health Ministry (Programme Hospitalier de Recherche Clinique, PHRC, CHU de Grenoble).

Competing Interests

All the authors declare that they have no significant competing financial, professional or personal interests that might have influenced the performance or presentation of the work described in this manuscript.

Contributorship

The following authors have participated in the:

Study design: AL, JPR, CC, MM

Data collection: EBZ, FA, PLC, AB, FV, SB, AB, MM

Statistical analysis: EBZ, CC

Manuscript writing: EBZ, AB, CC, MM

Author information

Authors and Affiliations

  1. UJF-Grenoble 1, Grenoble, F-38041, France

    E. Brillat-Zaratzian, F. Aptel, J. P. Romanet, M. Maurin & C. Chiquet

  2. Department of Ophthalmology, University Hospital, 38043, Grenoble cedex 09, France

    E. Brillat-Zaratzian, F. Aptel, J. P. Romanet & C. Chiquet

  3. Department of Ophthalmology, University Hospital, Dijon, France

    A. Bron

  4. Department of Ophthalmology, University Hospital Edouard Herriot, Civil Hospices of Lyon, University Lyon I, Lyon, France

    P. L. Cornut

  5. Department of Microbiology, University Hospital, University Lyon I, Lyon, France

    F. Vandenesch & S. Boisset

  6. Department of Microbiology, University Hospital, Grenoble, F-38043, France

    M. Maurin

Authors
  1. E. Brillat-Zaratzian
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Bron
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Aptel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. P. Romanet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P. L. Cornut
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F. Vandenesch
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. Boisset
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M. Maurin
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. C. Chiquet
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Chiquet.

Additional information

The FRIENDS group: FRench Institutional ENDophthalmitis Study group

Participants:

Study coordinator: Christophe Chiquet

Statistics, methodology, microbiological techniques:

François Vandenesch, Max Maurin

Database management:

Pierre-Loïc Cornut

Ophthalmology:

- University Hospital of Dijon: Pierre-Olivier Lafontaine, Marie Passemard, Catherine Creuzot-Garcher, Alain Bron

- University Hospital of Grenoble: Christophe Chiquet, Karine Palombi, Florent Aptel, Jean-Paul Romanet

- University Hospital of Lyon (E. Herriot Hospital): Pierre-Loïc Cornut, Frédéric Rouberol, Philippe Denis

- University Hospital of Saint-Etienne: Gilles Thuret, Philippe Gain

Microbiology:

- University Hospital of Dijon: André Péchinot, Catherine Neuwirth

- University Hospital of Grenoble: Sandrine Boisset, Max Maurin

- University Hospital of Lyon: Jérôme Etienne, Yvonne Benito, Anne Tristan, François Vandenesch

- University Hospital of Saint-Etienne: Anne Carricajo, Gérard Aubert

Mycology:

- University Hospital of Dijon: Frédéric Dalle, Alain Bonin

- University Hospital of Grenoble: Bernadette Lebeau, Hervé Pelloux

- University Hospital of Lyon: Frédérique de Montbrison, Stéphane Picot

- University Hospital of Saint-Etienne: Hélène Raberin, Roger Tran Manh Sung

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brillat-Zaratzian, E., Bron, A., Aptel, F. et al. FRIENDS Group: clinical and microbiological characteristics of post-filtering surgery endophthalmitis. Graefes Arch Clin Exp Ophthalmol 252, 101–107 (2014). https://doi.org/10.1007/s00417-013-2503-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-013-2503-4

Keywords

Search

Navigation