Purpose: The purpose of this study is to describe an updated microbiology spectrum and antibiotic sensitivities of organisms causing infectious endophthalmitis in Queensland, Australia and compare this to other parts of Australia and countries. It will assess the role of tap and inject verse early and late pars-plana-vitrectomy in the management of infectious endophthalmitis in relation to final visual acuity obtained.
Method: A retrospective consecutive cohort study was performed on all patients who underwent an anterior or vitreous chamber paracentesis between January 2014 and December 2019. Outcome measures were endophthalmitis aetiology, vitreous isolates, antibiotic sensitivities and final visual acuity.
Results: One hundred and two cases of endophthalmitis were identified (74 exogenous, 28 endogenous). Forty-nine cases returned culture positive vitreous isolates with gram-positive (69%), fungal (21%), gram-negative (10%). Most common organisms cultured were Staphylococcus epidermidis (23%), Candida species (12%), Coagulase-negative Staphylococcus (10%) and Staphylococcus aureus (10%). Vancomycin and co-trimoxazole were 100% sensitive against gram-positive and ceftazidime and gentamicin were 100% sensitive against gram-negative cultured organisms. Amphotericin and voriconazole were 100% sensitive for fungal isolates. There was no difference in final visual acuity outcomes between early (within 72 hours) verse late vitrectomy. However, both were significantly better than tap and injection alone.
Conclusion: The microbiological spectrum and antibiotic sensitivities of infectious endophthalmitis in Queensland, Australia is comparable to other parts of Australia and North America. Medical treatment may not be as effective as vitrectomy in improving final visual acuity in these patients while early and late vitrectomy have similar outcomes.