Epidemiology and Treatment Trends in North America

Chapter
First Online:

Abstract

In North America, bacteria and less commonly fungi or parasites are responsible for exogenous endophthalmitis. They may originate from the rich conjunctival and eyelid flora, from airborne particles or contaminated surgical devices. While not much has been published on the North American patient population recently, the continued understanding is that lid and conjunctival flora remain the main source of pathogens for endophthalmitis caused by access to the intraocular space through an open or incompletely sealed wound.

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

References

  1. 1.
    Speaker MG, Milch FA, Shah MK, et al. Role of external bacterial flora in the pathogenesis of acute postoperative endophthalmitis. Ophthalmology. 1991;98:639–50.CrossRefPubMedGoogle Scholar
  2. 2.
    Rodin FH. Bacteriologic study of human conjunctival flora*. Am J Ophthalmol. 1945;28:306–14.CrossRefGoogle Scholar
  3. 3.
    Kim SJ, Toma HS, Midha NK, et al. Antibiotic resistance of conjunctiva and nasopharynx evaluation study: a prospective study of patients undergoing intravitreal injections. Ophthalmology. 2010;117:2372–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Chen X, Adelman RA. Microbial spectrum and resistance patterns in endophthalmitis: a 21-year (1988-2008) review in northeast United States. J Ocular Pharmacol Ther. 2012;28:329–34.CrossRefGoogle Scholar
  5. 5.
    Schimel AM, Miller D, Flynn HW Jr. Endophthalmitis isolates and antibiotic susceptibilities: a 10-year review of culture-proven cases. Am J Ophthalmol. 2013;156:50–2.CrossRefPubMedGoogle Scholar
  6. 6.
    Gentile RC, Shukla S, Shah M, et al. Microbiological spectrum and antibiotic sensitivity in endophthalmitis: a 25-year review. Ophthalmology. 2014;121:1634–42.CrossRefPubMedGoogle Scholar
  7. 7.
    Khera M, Pathengay A, Jindal A, et al. Vancomycin-resistant Gram-positive bacterial endophthalmitis: epidemiology, treatment options, and outcomes. J Ophthalmic Inflam Inf. 2013;3:46. https://doi.org/10.1186/1869-5760-3-46.CrossRefGoogle Scholar
  8. 8.
    West ES, Behrens A, McDonnell PJ, et al. The incidence of endophthalmitis after cataract surgery among the U.S. medicare population increased between 1994 and 2001. Ophthalmology. 2005;112:1388–94.CrossRefPubMedGoogle Scholar
  9. 9.
    Du DT, Wagoner A, Barone SB, et al. Incidence of endophthalmitis after corneal transplant or cataract surgery in a medicare population. Ophthalmology. 2014;121:290–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Coleman AL. How big data informs Us about cataract surgery: the LXXII Edward Jackson memorial lecture. Am J Ophthalmol. 2015;160:1091–103.CrossRefPubMedGoogle Scholar
  11. 11.
    Jensen MK, Fiscella RG, Crandall AS, et al. A retrospective study of endophthalmitis rates comparing quinolone antibiotics. Am J Ophthalmol. 2005;139:141–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Jensen MK, Fiscella RG, Moshirfar M, Mooney B. Third- and fourth-generation fluoroquinolones: retrospective comparison of endophthalmitis after cataract surgery performed over 10 years. J Cataract Refract Surg. 2008;34:1460–7.CrossRefPubMedGoogle Scholar
  13. 13.
    Mistlberger A, Ruckhofer J, Raithel E, et al. Anterior chamber contamination during cataract surgery with intraocular lens implantation. J Cataract Refract Surg. 1997;23:1064–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Baillif S, Roure-Sobas C, Le-Duff F, Kodjikian L. Aqueous humor contamination during phacoemulsification in a university teaching hospital. J Fr Ophtalmol. 2012;35:153–6.CrossRefPubMedGoogle Scholar
  15. 15.
    Han DP, Wisniewski SR, Wilson LA, et al. Spectrum and susceptibilities of microbiologic isolates in the Endophthalmitis Vitrectomy Study. Am J Ophthalmol. 1996;122:1–17.CrossRefPubMedGoogle Scholar
  16. 16.
    Gower EW, Keay LJ, Stare DE, et al. Characteristics of endophthalmitis after cataract surgery in the United States medicare population. Ophthalmology. 2015;122:1625–32.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Lalwani GA, Flynn HW Jr, Scott IU, et al. Acute-onset endophthalmitis after clear corneal cataract surgery (1996–2005). Ophthalmology. 2008;115:473–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Teng YT, Teng MC, Kuo HK, et al. Isolates and antibiotic susceptibilities of endophthalmitis in post cataract surgery: a 12-year review of culture-proven cases. Int Ophthalmol. 2017;37:513–8. https://doi.org/10.1007/s10792-016-0288-2.CrossRefPubMedGoogle Scholar
  19. 19.
    Doft BH. Treatment of post cataract extraction endophthalmitis: a summary of the results from the Endophthalmitis Vitrectomy Study. Arch Ophthalmol. 2008;126:554–6.CrossRefPubMedGoogle Scholar
  20. 20.
    Iyer MN, Han DP, Yun HJ, et al. Subconjunctival antibiotics for acute post cataract extraction endophthalmitis—is it necessary? Am J Ophthalmol. 2004;137:1120–1.CrossRefPubMedGoogle Scholar
  21. 21.
    Smiddy WE, Smiddy RJ, BaʼArath B, et al. Subconjunctival antibiotics in the treatment of endophthalmitis managed without vitrectomy. Retina. 2005;25:751–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Kuhn F, Gini G. Ten years after … are findings of the Endophthalmitis Vitrectomy Study still relevant today? Graefes Arch Clin Exp Ophthalmol. 2005;243:1197–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Hariprasad SM, Shah GK, Mieler WF, et al. Vitreous and aqueous penetration of orally administered moxifloxacin in humans. Arch Ophthalmol. 2006;124:178–82.CrossRefPubMedGoogle Scholar
  24. 24.
    Fuller JJ, Lott MN, Henson NM, et al. Vitreal penetration of oral and topical moxifloxacin in humans. Am J Ophthalmol. 2007;143:338–40.CrossRefPubMedGoogle Scholar
  25. 25.
    Lott MN, Fuller JJ, Hancock HA, et al. Vitreal penetration of oral moxifloxacin in humans. Retina. 2008;28:473–6.CrossRefPubMedGoogle Scholar
  26. 26.
    Ciulla TA, Starr MB, Masket S. Bacterial endophthalmitis prophylaxis for cataract surgery. Ophthalmology. 2002;109:13–24.CrossRefPubMedGoogle Scholar
  27. 27.
    ESCRS Endophthalmitis Study Group. Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg. 2007;33:978–88.CrossRefGoogle Scholar
  28. 28.
    Ho PC, Tolentino FI. Bacterial endophthalmitis after closed vitrectomy. Arch Ophthalmol. 1984;102:207–10.CrossRefPubMedGoogle Scholar
  29. 29.
    Cohen SM, Flynn HW, Murray TG, Smiddy WE. Endophthalmitis after pars plana vitrectomy. The Postvitrectomy Endophthalmitis Study Group. Ophthalmology. 1995;102:705–12.CrossRefPubMedGoogle Scholar
  30. 30.
    Eifrig CWG, Scott IU, Flynn HW Jr, et al. Endophthalmitis after pars plana vitrectomy: incidence, causative organisms, and visual acuity outcomes. Am J Ophthalmol. 2004;138:799–802.CrossRefPubMedGoogle Scholar
  31. 31.
    Kunimoto DY, Kaiser RS, Wills Eye Retina Service. Incidence of endophthalmitis after 20- and 25-gauge vitrectomy. Ophthalmology. 2007;114:2133–7.CrossRefPubMedGoogle Scholar
  32. 32.
    Scott IU, Flynn HW, Dev S, et al. Endophthalmitis after 25-gauge and 20-gauge pars plana vitrectomy: incidence and outcomes. Retina. 2008;28:138–42.CrossRefPubMedGoogle Scholar
  33. 33.
    Scott IU, Flynn HW, Acar N, et al. Incidence of endophthalmitis after 20-gauge vs 23-gauge vs 25-gauge pars plana vitrectomy. Graefes Arch Clin Exp Ophthalmol. 2011;249:377–80.CrossRefPubMedGoogle Scholar
  34. 34.
    Kaiser RS, Prenner J, Scott IU, et al. The Microsurgical Safety Task Force: evolving guidelines for minimizing the risk of endophthalmitis associated with microincisional vitrectomy surgery. Retina. 2010;30:692–9.CrossRefPubMedGoogle Scholar
  35. 35.
    Garg SJ, Dollin M, Storey P, et al. Microbial spectrum and outcomes of endophthalmitis after intravitreal injection versus pars plana vitrectomy. Retina. 2016;36:351–9.CrossRefPubMedGoogle Scholar
  36. 36.
    Mccannel CA. Meta-analysis of endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents. Retina. 2011;31:654–61.CrossRefPubMedGoogle Scholar
  37. 37.
    Fileta JB, Scott IU, Flynn HW. Meta-analysis of infectious endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents. Ophthalmic Surg Lasers Imaging Retina. 2014;45:143–9.CrossRefPubMedGoogle Scholar
  38. 38.
    Rayess N, Rahimy E, Storey P, et al. Post injection endophthalmitis rates and characteristics following intravitreal bevacizumab, ranibizumab, and aflibercept. Am J Ophthalmol. 2016;165:88–93.CrossRefPubMedGoogle Scholar
  39. 39.
    Bhavsar AR, Glassman AR, Stockdale CR, Jampol LM, Diabetic Retinopathy Clinical Research Network. Elimination of topical antibiotics for intravitreous injections and the importance of using povidone-iodine: update from the Diabetic Retinopathy Clinical Research Network. JAMA Ophthalmol. 2016;134:1181. https://doi.org/10.1001/jamaophthalmol.2016.2741.CrossRefPubMedGoogle Scholar
  40. 40.
    Shah CP, Garg SJ, Vander JF, et al. Outcomes and risk factors associated with endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents. Ophthalmology. 2011;118:2028–34.CrossRefPubMedGoogle Scholar
  41. 41.
    Englander M, Chen TC, Paschalis EI, et al. Intravitreal injections at the Massachusetts Eye and Ear Infirmary: analysis of treatment indications and post injection endophthalmitis rates. Br J Ophthalmol. 2013;97:460–5.CrossRefPubMedGoogle Scholar
  42. 42.
    Fineman MS, Hsu J, Spirn MJ, Kaiser RS. Bimanual assisted eye lid retraction techniques for intravitreal injections. Retina. 2013;33:1968–70.CrossRefPubMedGoogle Scholar
  43. 43.
    Kim SJ, Toma HS. Antimicrobial resistance and ophthalmic antibiotics: 1-year results of a longitudinal controlled study of patients undergoing intravitreal injections. Arch Ophthalmol. 2011;129:1180–8.CrossRefPubMedGoogle Scholar
  44. 44.
    Milder E, Vander J, Shah C, Garg S. Changes in antibiotic resistance patterns of conjunctival flora due to repeated use of topical antibiotics after intravitreal injection. Ophthalmology. 2012;119:1420–4.CrossRefPubMedGoogle Scholar
  45. 45.
    Storey P, Dollin M, Pitcher J, et al. The role of topical antibiotic prophylaxis to prevent endophthalmitis after intravitreal injection. Ophthalmology. 2014;121:283–9.CrossRefPubMedGoogle Scholar
  46. 46.
    Li AL, Wykoff CC, Wang R, et al. Endophthalmitis after intravitreal injection: role of prophylactic topical ophthalmic antibiotics. Retina. 2016;36:1349–56.CrossRefPubMedGoogle Scholar
  47. 47.
    Hsu J, Gerstenblith AT, Garg SJ, Vander JF. Conjunctival flora antibiotic resistance patterns after serial intravitreal injections without post injection topical antibiotics. Am J Ophthalmol. 2014;157:514–8.CrossRefPubMedGoogle Scholar
  48. 48.
    Avery RL, Bakri SJ, Blumenkranz MS, et al. Intravitreal injection technique and monitoring. Retina. 2014;34:S1–S18.CrossRefPubMedGoogle Scholar
  49. 49.
    Arora KS, Robin AL, Corcoran KJ, et al. Use of various glaucoma surgeries and procedures in medicare beneficiaries from 1994 to 2012. Ophthalmology. 2015;122:1615–24.CrossRefPubMedGoogle Scholar
  50. 50.
    Vaziri K, Kishor K, Schwartz SG, et al. Incidence of bleb-associated endophthalmitis in the United States. Clin Ophthalmol. 2015;9:317–22.PubMedPubMedCentralGoogle Scholar
  51. 51.
    Busbee BG, Recchia FM, Kaiser R, et al. Bleb-associated endophthalmitis: clinical characteristics and visual outcomes. Ophthalmology. 2004;111:1495–503. discussion 1503.CrossRefPubMedGoogle Scholar
  52. 52.
    Jacobs DJ, Leng T, Flynn HW, et al. Delayed-onset bleb-associated endophthalmitis: presentation and outcome by culture result. Clin Ophthalmol. 2011;5:739–44.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Leng T, Miller D, Flynn HW, et al. Delayed-onset bleb-associated endophthalmitis (1996-2008): causative organisms and visual acuity outcomes. Retina. 2011;31:344–52.CrossRefPubMedGoogle Scholar
  54. 54.
    Suto C, et al. Conjunctival sac bacterial flora isolated prior to cataract surgery. Infect Drug Resist. 2012;5:37–41.PubMedPubMedCentralGoogle Scholar
  55. 55.
    Honda R, Toshida H, Suto C, et al. Effect of long-term treatment with eye drops for glaucoma on conjunctival bacterial flora. Infect Drug Resist. 2011;4:191–6.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Retinal Consultants of AZPhoenixUSA

Personalised recommendations