de Esteban Maciñeira Elia, Bande Manuel F, Soberanes-Pérez Jorge Ivan, Paniagua Laura, Golzarri Maria F, Fromow-Guerra Jans, Blanco Teijeiro María José, Touriño Peralba Rosario
Servicio de Oftalmología, Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain.
Unidad de Retina, Asociación para Evitar la Ceguera en México, Ciudad de Mexico 04030, Mexico.
J Clin Med. 2024 Aug 23;13(17):4990. doi: 10.3390/jcm13174990.
The aim of this study was to investigate endogenous endophthalmitis (EE) in Spain and Mexico, focusing on microbial patterns, antibiotic resistance, infection sources, risk factors, and patient outcomes. Over 20 years, 705 endophthalmitis cases were reviewed, and we identified 78 cases of EE in Santiago de Compostela, Spain, and Mexico City, Mexico. Microbial etiology, infection sources, antibiotic resistance, and treatment outcomes were compared between patients from Spain and Mexico. Among the 78 EE cases, 47 (60.25%) were from Spain and primarily had bacterial infections (57.1%, mainly Staphylococcus and Streptococcus). In contrast, 31 cases (39.74%) were from Mexico and had a higher prevalence of fungal infections, particularly Candida (47.1%). Diabetes mellitus was a significant risk factor, and was more common in Mexico (61.3%) than in Spain (37.0%). The Spanish cohort exhibited notable antibiotic resistance, especially in Staphylococcus. Treatment typically involved systemic and intraocular antibiotics, with vitrectomy performed in 61.5% cases. Post-treatment, bacterial infections had higher success rates (approximately 50%) compared with fungal infections (approximately 30%). Evisceration was necessary in 9% cases, and the overall mortality rate was approximately 4.4%; it was slightly higher in Mexico than in Spain. The study highlights significant regional differences in EE between Spain and Mexico, particularly regarding microbial etiology and antibiotic resistance. The findings emphasize the need to adapt healthcare practices to specific regions to improve EE treatment outcomes, underscoring the importance of ongoing research and interregional collaboration to better understand and manage this complex condition.
本研究旨在调查西班牙和墨西哥的内源性眼内炎（EE），重点关注微生物模式、抗生素耐药性、感染源、危险因素和患者预后。在20多年的时间里，对705例眼内炎病例进行了回顾，我们在西班牙的圣地亚哥-德孔波斯特拉和墨西哥城识别出78例EE病例。比较了西班牙和墨西哥患者的微生物病因、感染源、抗生素耐药性和治疗结果。在这78例EE病例中，47例（60.25%）来自西班牙，主要为细菌感染（57.1%，主要是葡萄球菌和链球菌）。相比之下，31例（39.74%）来自墨西哥，真菌感染的患病率更高，尤其是念珠菌（47.1%）。糖尿病是一个重要的危险因素，在墨西哥（61.3%）比在西班牙（37.0%）更常见。西班牙队列表现出显著的抗生素耐药性，尤其是葡萄球菌。治疗通常包括全身和眼内使用抗生素，61.5%的病例进行了玻璃体切除术。治疗后，细菌感染的成功率（约50%）高于真菌感染（约30%）。9%的病例需要进行眼球摘除术，总体死亡率约为4.4%；墨西哥的死亡率略高于西班牙。该研究强调了西班牙和墨西哥在EE方面存在显著的地区差异，特别是在微生物病因和抗生素耐药性方面。研究结果强调需要根据特定地区调整医疗实践，以改善EE的治疗结果，凸显了持续研究和区域间合作对于更好地理解和管理这种复杂疾病的重要性。
