Analysis of pathogenic factors and etiological characteristics of 531 patients with suppurative endophthalmitis / 中华眼底病杂志

Objective To analyze pathogenic factors and etiological characteristics of suppurative endophthalmitis.Methods A total of 531 consecutive patients (531 eyes) with suppurative endophthalmitis who were hospitalized in Qingdao Eye Hospital of Shandong Eye Institute from January 2006 to December 2015 were included in the study.Among them,410 patients with 410 eyes were males (77.2％),121 patients with 121 eyes were females (22.8％).The average age of the patients was 38.62± 15.36 years.The relevant medical records were collected to analyze the pathogenic factors.Samples of aqueous humor,vitreous or other intraocular samples were taken under aseptic conditions for bacterial and fungal culture and in vitro drug sensitivity test.Results Ocular trauma was the primary pathogenic factor of suppurative endophthalmitis (60.1％),other factors included postoperative endophthalmitis (19.0％),suppurative keratitis-related endophthalmitis (17.1％) and endogenous endophthalmitis (3.8％).Postoperative endophthalmitis mainly occured after cataract surgery.A total of 224 strains of organisms were isolated,among which the predominant organisms isolated were gram-positive bacteria (54.0％) and staphylococcus epidermidis was the most common (25.0％).The other pathogenic organisms were fungi (29.5％) and gram-negative bacteria (16.5％).Among the fungi,aspergillus (10.7％) was the dominant genus,followed by fusarium (9.8％).For gram-positive organisms,susceptibilities were vancomycin 97.4％,gatifloxacin 91.8％,fusidate acid 77.9％ and levofloxacin 54.6％.For gram-negative organisms,susceptibilities were gatifloxacin 85.7％,levofloxacin 77.8％,tobramycin 71.4％ and ceftazidime 62.5％.For fungal isolates,sensitivities were voriconazole 88.2％ and amphotericin B 84.8％.Conclusions Ocular trauma is the main pathogenic factor of suppurative endophthalmitis,followed by postoperative endophthalmitis and suppurative keratitis-related endophthalmitis.Gram-positive bacteria are the major pathogenic organisms,especially staphylococcus epidermidis followed by fungal species,among which aspergillus and fusarium were the dominating pathogenic genus.

Identification of pathgenic bacteria in aqueous and vitreous of endophthalmitis by 16S rDNA sequencing technique / 中华实验眼科杂志

Background Endophthalmitis is a serious complication of intraocular surgery.Conventional identification methods for bacteria are becterial culture and smear method,but these laboratory tests spend a long time and have low positive rates.16S rDNA is the bacterial chromosome encoding ribosomal RNA sequences,and it is determined that 16S rDNA sequencing has a high specificity for the identification of bacteria.Objective This study was to identify the infectious bacteria from aqueous humor or vitreous body in the eyes with endophthalmitis by 16S rDNA sequencing technique,and to investigate the diagnosis efficency of 16S rDNA sequencing technique on bacterial endophthalmitis.Methods Anterior chamber fluid (0.1-0.2 ml) or vitreous humor (0.5-1.0 ml) specimens were collected from 5 eyes of 5 patients with endophthalmitis in Qingdao Eye Hospital from June to December 2015 and used for high throughput sequencing,bacterial culture and smear,respectively.Bacteria DNA was extracted from the specimen with D3096-01 trace DNA kit for the amplification of V3-V4 region of 16S rRNA gene and sequencing of hypervariable region of all microbes in the samples by MiSeq Illumina Sequencing Platform.Then the bioinformatic analysis including analysis of taxonomy,abundance and alpha diversity were performed.Nucleasefree water of 50 μl in the centrifuge tube was used as control.Results Five aqueous humor or vitreous body samples were collected,and the positive results were exhibited by smear examination,with the Gram positive bacilli in the trumatic endophthalmitis eye and Gram negative bacilli in the filtering bleb infectious endophthalmitis eye,and all culture results were negative.16S rDNA squencing showed the positive outcomes in all the 5 samples.The high abundent nacteral genuses were Staphylococcus (65.28％),Streptococcus (18.90％) and Pseudomonas (12.76％) in the trumatic endophthalmitis eye;the major components of sample were Pseudomonas (53.68％),Acinetobacter (8.62％) and Limnobacter (5.96％) in the eye with acute endophthalmitis occurring at 2 days following cataract surgery;the major components in the filtering bleb infectious endophthalmitis eye were Moraxella (88.89％) and Pseudomonas (9.52％);the Pseudomonas was major components in the later-onset endophthalmitis eye (84.63％) and the eye with acute endophthalmitis occurring at 1 day after cataract surgery (97.89％).Conclusions A distinct advantage is found in 16S rDNA sequencing technique for the indentification of the pathogenic bacteria in endophthalmitis eyes due to its high positive rate in comparison with bacterial culture and smear method.

Clinical analysis of 282 patients with infectious endophthalmitis / 中华眼底病杂志

Objective To analyze the causes and pathogens of infectious endophthalmitis in ourhospital.Methods The clinical data and laboratory findings of 282 inpatients with infectiousendophthalmitis were retrospectively reviewed.There were 206 males(73.05%)and 76 females(26.95%)with a mean age of(36.0±11.2)years(range from 2 to 79 years).Except 14 patients who lost theireyeballs as of serious conditions.pathogen examinations of vitreous specimen had been performed for allremaining 268 cases.The clinieal and laboratory data were statistically analyzed by Chi-square and Kappaconsistency tests,when P<0.05 the difference should be considered as statistically significant.ResultsThe 4 major causes of infectious endophthalmitis of those 282 patients included ocular trauma(177cases,62.77%),infectious keratitis(61 cases,21.63%),eye surgery(32 cases,11.35%),andendogenous endophthalmitis(12 cases,4.25%).19.21% of the patients in ocular trauma group was 2-13years old,55.74% of the patients in infectious keratitis group was 14-50 years old,and 60.61% of thepatients in eye surgery group was 51-79 years old.The major pathogens were fungus and staphylococcieach accounted for 30.63% of all cases.Most of the pathogenic bacteria were sensitive to ciprofloxaein(81.81%)and gentamicin(77.92%).Conclusions The major reason of infectious endophthalmitis wasocular trauma,and the major pathogens were fungus and staphylococci.Those findings may help us totreat infectious endophthalmitis patients appropriately.

Infected endophthalmitis diagnosed by multiplex polymerase chain reaction / 中华眼底病杂志

Objective To evaluate the rapid diagnosis of bacterial and (or) fungal endophthalmitis by multiplex polymerase chain reaction (MPCR). Methods MPCR was performed to detect the DNA segment of bacteria and (or) fungi from standard strains and 41 samples of intraocular fluid or vitreous from 38 patients (3 with double eyes and 35 with single), and the results were compared with the cultured bacteria and fungi. Results Five hours after detected by MPCR, bacteria and (or) fungi in 34 out of 41 samples (82.9%) from patients were detected,including bacteria in 26,fungi in 6,and both bacteria and fungi in 2. The positive rate of MPCR was obviously higher than the cultured ones( ? 2 =9.60, P

The clinical analysis on bacterial isolates from the aqueous humor and the vitreous body of patients with suspected endophthalmitis / 中华眼底病杂志

Objective To review the distribution and shifting trends of cultured bacteria from the aqueous humor and the vitreous body. Methods A retrospective analysis on distribution of Gram′s stain, the distribution and change of isolates was performed in 522 specimens (aqueous humor,261 and vitreous body,261) of patients with suspected endophthalmitis during a 10 year period (1989 1998). Results The positive cultures were 119 (aqueous humor,44 and vitreous body,75) of 522 specimens. The average positive rate was 22.8%. Gram positive cocci constituting 45.4%(54) of total isolates followed by Gram negative bacilli,34.5%(41);Gram positive bacilli, 20.2%(24). In the positive bacterial cultures, enterobacteriaceae was the most common isolate, 18.5%, and the next was micrococcus, 16.0%; coagulase negative staphylococcus,12.6%; and pseudomonas,10.9%.Comparing the data from 1989 through 1993 with the data from 1994 through 1998, the frequency of Gram positive cocci had no significant change, while the frequency of Gram positive bacilli was decreased and the percentage of Gram′s negative bacilli was increased. Conclusions Gram positive cocci and Gram negative bacilli are the predominant pathogens of bacterial endophthalmitis. The percentage of Gram′s negative bacilli has increased for 5 years. It is very important to comprehend the distribution and shifting trends of these pathogenic bacteria for diagnosis, prevention and treatment of bacterial endophthalmitis.