Chen Kuan-Jen, Lai Chi-Chun, Chen Hung-Chi, Chong Ying-Jiun, Sun Ming-Hui, Chen Yen-Po, Wang Nan-Kai, Hwang Yih-Shiou, Chao An-Ning, Wu Wei-Chi, Yeung Ling, Sun Chi-Chin, Liu Laura, Chen Yi-Hsing, Chou Hung-Da
Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Microorganisms. 2021 Apr 24;9(5):918. doi: 10.3390/microorganisms9050918.
is known to cause severe acute endophthalmitis and often leads to poor visual outcomes in most ophthalmic infections. This retrospective study is to report the clinical settings, antimicrobial susceptibility patterns, and visual outcome of endophthalmitis at a tertiary referral institution in Taoyuan, Taiwan. endophthalmitis was diagnosed in 37 eyes of 37 patients. Post-cataract surgery was the most common cause ( = 27, 73%), followed by bleb-associated ( = 3, 8%), endogenous ( = 2, 5%), corneal ulcer-related ( = 2, 5%), post-vitrectomy ( = 1, 3%), post-pterygium excision ( = 1, 3%), and trauma ( = 1, 3%). Visual acuities upon presentation ranged from counting fingers to no light perception. Pars plana vitrectomy with intravitreal antibiotics were performed in 23 eyes (76%) as primary or secondary treatment. All isolates (37/37, 100%) were sensitive to vancomycin, penicillin, ampicillin, and teicoplanin. Six of 22 eyes (27%) were resistant to high-level gentamicin (minimum inhibitory concentration > 500 mg/L). Final visual acuities were better than 20/400 in 11 eyes (30%), 5/200 to hand motions in 4 eyes (11%), and light perception to no light perception in 22 eyes (59%). Three eyes were treated with evisceration. Compared with non-cataract subgroups, the post-cataract subgroup showed a significant difference of better visual prognosis ( = 0.016).
已知其可引发严重的急性眼内炎,并且在大多数眼科感染中常常导致不良的视力预后。本回顾性研究旨在报告台湾桃园一家三级转诊机构中眼内炎的临床情况、抗菌药物敏感性模式及视力预后。37例患者的37只眼被诊断为眼内炎。白内障手术后是最常见的病因(n = 27,73%),其次是与滤过泡相关的(n = 3,8%)、内源性的(n = 2,5%)、角膜溃疡相关的(n = 2,5%)、玻璃体切除术后的(n = 1,3%)、翼状胬肉切除术后的(n = 1,3%)以及外伤(n = 1,3%)。就诊时的视力范围从数指到无光感。23只眼(76%)接受了玻璃体切割联合玻璃体内注射抗生素作为主要或次要治疗。所有分离菌株(37/37,100%)对万古霉素、青霉素、氨苄西林和替考拉宁敏感。22只眼中有6只(27%)对高浓度庆大霉素耐药(最低抑菌浓度>500mg/L)。最终视力优于20/400的有11只眼(30%),5/200至手动的有4只眼(11%),光感至无光感的有22只眼(59%)。3只眼接受了眼球摘除术。与非白内障亚组相比,白内障术后亚组的视力预后明显更好(P = 0.016)。