ABSTRACT NUMBER - 112

ENDOPHTHALMITIS: RELATIONSHIP OF PRECIPITATING EVENT AND MICROBIOLOGY


Andrew Hurley1,2, Penelope Allen1,3, Rosie Dawkins1,3, Will Atkins-Brown3,4

Meeting:  2018 RANZCO


SESSION INFORMATION

Date:      -

Session Title: POSTER ABSTRACT- RETINA

Session Time:      -

Purpose: Different precipitating events causing endophthalmitis introduce different microorganisms into the eye. We aim to establish the leading micro- bial causes in Victoria for each precipitating event and measure outcomes.
Method: Data was collected prospectively in the Victorian Endophthalmitis Registry from 1/1/2007 to 31/12/2017 at the Royal Victorian Eye and Ear Hospital (RVEEH), currently held as an online data- base created with REDCap. This captures all cases of endophthalmitis at the RVEEH with catchment throughout the state of Victoria. To ensure complete- ness, cross-checking against discharge diagnosis and data in-fill was undertaken.
Results: In the 10 year time period 522 endophthal- mitis cases were recorded. Cataract surgery associ- ated endophthalmitis (n = 159) resulted in mostly gram-positive organisms (51.0%), particularly coag- ulase negative staphylococcus species (27.1%). Intravitreal injection associated endophthalmitis (n = 117) resulted in some coagulase negative staph- ylococcus (29.9%), but also more streptococcal infec- tions (17.1%) as compared to cataract surgery (11.9%). Glaucoma drainage surgery (n = 58) intro- duced a range of organisms, notably gram-negative organisms (17.2%). Endogenous endophthalmitis (n = 76) was commonly caused by fungal infection (26.3%), particularly Candida albicans, though some unusual organisms were cultured. Corneal ulcera- tion (n = 56) was the precipitating event with the worst outcomes with 32% of patients receiving enucleation.
Conclusion: Clinicians should be aware of likely microorganisms according to precipitating factor, so they can prescribe the appropriate empirical intravi- treal antibiotics, and arrange early vitrectomy for more aggressive disease. This data confirms that the empirical endophthalmitis protocol at the RVEEH remains appropriate for the Victorian clinical pattern of microbiology.

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