Unusual microbiological presentations in polymicrobial post-operative endophthalmitis and their clinical correlations

• Published in: International ophthalmology Vol. 39; no. 9; pp. 2143 - 2148
• Main Authors: Mitra, Sanchita, Padhi, Tapas Ranjan, Basu, Soumyava, Priyadarshini, Smruti Rekha, Sharma, Savitri
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.09.2019; Springer Nature B.V
• Subjects: Adolescent; Aeromonas veronii; Aged; Antibiotics; Antimicrobial agents; Bacteria - isolation & purification; Burkholderia cepacia; Case Report; Cornea; Endophthalmitis; Endophthalmitis - diagnosis; Endophthalmitis - microbiology; Enterococcus faecalis; Eye Infections, Bacterial - diagnosis; Eye Infections, Bacterial - microbiology; Female; Humans; Male; Medicine; Medicine & Public Health; Microbial Sensitivity Tests; Microbiology; Microorganisms; Ophthalmology; Organisms; Sensitivity; Sphingomonas paucimobilis; Streptococcus infections; Streptococcus pneumoniae; Surgical Wound Infection - diagnosis; Surgical Wound Infection - microbiology; Visual Acuity; Vitrectomy - adverse effects; Vitreous Body - microbiology; Young Adult; Endophthalmitis; Polymicrobial; Antimicrobial resistance
• ISSN: 0165-5701; 1573-2630; 1573-2630
• DOI: 10.1007/s10792-018-1019-7

Purpose To report the clinical course, microbiological spectrum and visual outcomes of three cases of post-operative endophthalmitis caused by unusual combination of micro-organisms. Methods Retrospective review of medical charts at a tertiary eye care centre over a period of 1 year, of subjects with post-operative endophthalmitis and more than one microbiological isolate. Results We report 3 cases with unusual combination of microorganisms. In case 1, two organisms ( Burkholderia cepacia and Aeromonas veronii , from the vitreous cavity and capsular bag, respectively ) with an identical antibiotic sensitivity pattern were found, while in case 2, the organisms ( Streptococcus pneumoniae and Sphingomonas paucimobilis , from cornea and vitreous cavity, respectively ) isolated had different sensitivity patterns. In case 3, two different strains of the same organism ( Enterococcus faecalis) were found. Cases 1 and 2 achieved good anatomical and visual outcomes, while in case 3, vision remained poor despite a good anatomical outcome. Conclusion Unusual combinations of organisms in post-operative endophthalmitis can introduce unique clinical characteristics and should specifically be considered in atypical clinical presentations, poor response to standard therapy and unusual recurrence patterns.