Yang Guoyuan, Huang Xi, Jiang Shanming, Xu Zhuping
Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China.
Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China,
Ophthalmic Res. 2020;63(5):507-516. doi: 10.1159/000505928. Epub 2020 Jan 15.
The aim of this study was to analyse the clinical features, microbiology results, management and outcomes of patients with endogenous endophthalmitis caused by Klebsiella pneumoniae in western China.
A retrospective review of medical records of 10 eyes in 10 subjects diagnosed with endogenous K. pneumoniae endophthalmitis from January 2008 to December 2018 was undertaken.
The top 3 predisposing medical conditions included diabetes mellitus (50%), malignancy (20%) and cardiac stent implantation (10%). Extraocular infective foci were mainly found in the liver (40%), lungs (20%) and kidneys (10%). The positive culture rate was 85.71% (6/7) in vitreous samples, 83.33% (5/6) in blood samples and 100% (4/4) in body fluid samples. Only 20% of the patients, who had good initial visual acuity (VA) better than hand movement (HM), achieved a final VA better than 1.0 (log MAR). The mortality rate was 10%.
Though the prognosis of endogenous K. pneumoniae endophthalmitis is often poor, patients with an initial VA better than HM may have a good prognosis under comprehensive treatments, including vitrectomy, systemic sensitive antibiotic injection and drainage of the primary infection loci.
本研究旨在分析中国西部肺炎克雷伯菌所致内源性眼内炎患者的临床特征、微生物学结果、治疗及预后。
对2008年1月至2018年12月期间确诊为肺炎克雷伯菌内源性眼内炎的10例患者的10只眼的病历进行回顾性分析。
前3位易患疾病包括糖尿病（50%）、恶性肿瘤（20%）和心脏支架植入术（10%）。眼外感染灶主要见于肝脏（40%）、肺（20%）和肾脏（10%）。玻璃体样本培养阳性率为85.71%（6/7），血液样本为83.33%（5/6），体液样本为100%（4/4）。初始视力（VA）优于手动（HM）的患者中，仅20%最终视力优于1.0（log MAR）。死亡率为10%。
尽管肺炎克雷伯菌内源性眼内炎的预后通常较差，但初始视力优于HM的患者在接受包括玻璃体切除术、全身注射敏感抗生素及引流原发感染灶在内的综合治疗后可能预后良好。
