Post-traumatic endophthalmitis caused by streptococcus species in preschool children: clinical features, antibiotic susceptibilities and outcomes

Yang, Yao; Sui, Wenjun; Duan, Fang; Li, Yujie; Zeng, Junfeng; Jiang, Zhaoxin; Liu, Manli; Yuan, Zhihang; Lin, Xiaofeng

doi:10.1038/s41433-021-01449-6

Cited by 6 publications

(9 citation statements)

References 27 publications

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“…It was consistent with previous reports. 3,8,[31][32][33][34] In our study, the pathogen identified was concordant in seven of 10 culture-positive cases. Discordance between mNGS and culture was also reported in the literature.…”

Section: Discussionsupporting

confidence: 63%

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Metagenomic Next-Generation Sequencing Detects Pathogens in Endophthalmitis Patients

Zhu

Tang

et al. 2022

Retina

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Purpose: To investigate the utility of metagenomic next-generation sequencing (mNGS) in identifying the pathogens in endophthalmitis.Methods: In this prospective study, 36 cases of endophthalmitis were recruited. All patients received surgical treatment and intraocular drug lavage. The samples of vitreous or aqueous humor were extracted for mNGS and microbiological culture. The diagnostic performance of pathogens was compared between mNGS and culture.Results: The positive rates of mNGS and culture were 88.89% (32/36) and 27.78% (10/ 36), respectively. There was a statistically significant difference between mNGS and culture (Chi-square = 27.657; P , 0.01). Staphylococcus epidermidis, Streptococcus pneumoniae, and Klebsiella pneumoniae were the most pathogenic bacteria in traumatic, postoperative, and endogenous endophthalmitis, respectively. The concordance of pathogen identified by mNGS and culture was 70% for culture-positive cases. Antibiotic resistance genes were identified in 9 cases. There was a marginal correlation between the final visual acuity and the microbial sequence read (Spearman correlation coefficient = 0.498; P = 0.05).Conclusion: Metagenomic next-generation sequencing has a higher positive rate of identifying pathogens in endophthalmitis than in culture. It can also provide information on antibiotic resistance and visual prognosis. However, caution must be taken when interpreting the results of mNGS because they may not be concordant with culture.

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Section: Discussionsupporting

confidence: 63%

“…E ndophthalmitis, one of the most severe ophthalmic emergencies, requires urgent treatment to save the vision or salvage the integrity of the eye. 1,2 The common causes of endophthalmitis include trauma, 3,4 intraocular surgery, 5,6 or endogenous dissemination. 7,8 Endophthalmitis may be caused by bacteria 8 or by fungi.…”

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confidence: 99%

Metagenomic Next-Generation Sequencing Detects Pathogens in Endophthalmitis Patients

Zhu

Tang

et al. 2022

Retina

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“…The most commonly identified organisms in our study were coagulase-negative staphylococci and S. aureus, comprising 50% of the isolates, as seen in other studies. 3,8,15 Culture-positive rates have been reported to range from 44% to 75% in Western studies. 11 Narang et al reported 27% culture positivity from ocular specimens in India.…”

Section: Discussionmentioning

confidence: 99%

Paediatric endophthalmitis: a 10-year retrospective study at Hospital Kuala Lumpur for incidence, risk factors, and outcomes

Dorairaja

Kadir

Rahmat

2022

MyJO

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Purpose: Paediatric infectious endophthalmitis is a serious sightthreatening disease for children. The purpose of this study was to investigate the incidence, aetiology, microbiological spectrum, management, and visual outcomes of infectious endophthalmitis in children referred to the Department of Ophthalmology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.Study design: Retrospective study.Methods: The medical records of all patients under 18 years of age with histories of endophthalmitis treated at Hospital Kuala Lumpur from January 2009 to December 2018 were reviewed. The clinical characteristics, aetiology, microbiological spectrum, management, as well as the visual outcomes were analysed.Results: A total of 23 children were identified, with a mean age of 3.15 (ranging from 20 days to 8 years of age). Previous ocular surgery (47.8%) and ocular trauma (30.4%) were the most common causes of endophthalmitis. Overall, eight (38.1%) cases with positive cultures were identified. The most commonly identified organism was Staphylococcus sp. comprising 50% of the isolates. Moreover, five isolates (62.5%) were gram-positive organisms and three isolates (37.5%) were gram-negative organisms. The final visual outcome was 20/200 or better in one eye (4.3 %), hand movement in two eyes (8.7%), light perception in five eyes (21.7%), and no light perception in 13 eyes (56.5%). The visual outcome was not available for two patients (8.7%).Conclusions: Previous ocular surgery and penetrating ocular trauma are the most frequent causes of paediatric endophthalmitis in our centre. Staphylococcus sp. was the most commonly identified organism in paediatric endophthalmitis. In this study, despite aggressive management with intravitreal antibiotics and vitrectomy, the visual prognosis was found to be generally poor.

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“…Streptococcus spp. are the leading cause of late bleb-related endophthalmitis and a common cause of post-traumatic endophthalmitis [ 15 , 16 ]. They are also frequently implicated after post-cataract surgery, vitrectomy, and intravitreal injection [ 15 , 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Features, Antibiotic Susceptibilities, and Outcomes of Endophthalmitis Caused by Streptococcal Infection: Children vs. Adults

Yang

Wong

et al. 2023

Antibiotics

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Streptococcus spp. are common causative organisms of endophthalmitis. Analysis of the clinical features, antibiotic susceptibilities, and outcomes of streptococcal endophthalmitis in children and adults may guide future management. Sixty-seven patients (67 eyes) with streptococcal endophthalmitis who were admitted to the Zhongshan Ophthalmic Center between January 2013 and December 2022 were retrospectively reviewed. The mean age was 20.7 ± 21.6 years, and 59.7% were children. Streptococcal infection accounted for 13.9% of culture-proven bacterial endophthalmitis cases; the proportion was higher in children than in adults (32.3% vs. 7.6%, p < 0.01) and increased from 8.1% in 2013–2017 to 20.1% in 2018–2022 (p < 0.01). Eye trauma was the most common etiology in both children and adults (82.5% and 66.7%, respectively). Viridans group streptococci were the most common isolates, followed by S. pneumoniae. The susceptibility rates of the streptococci to vancomycin, cefuroxime, and levofloxacin were 100%, 95.5%, and 93.0%, respectively. The overall mean best-corrected visual acuity increased from 2.74 ± 0.19 logMAR initially to 2.32 ± 0.75 logMAR at the last follow-up (p < 0.05). In conclusion, streptococcal infections have increased in cases of bacterial endophthalmitis in recent years and are more common in children. The commonly used antibiotics, vancomycin, cefuroxime, and fluoroquinolone, showed higher antibiotic susceptibility. After prompt treatment, visual outcomes improved.

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Post-traumatic endophthalmitis caused by streptococcus species in preschool children: clinical features, antibiotic susceptibilities and outcomes

Cited by 6 publications

References 27 publications

Metagenomic Next-Generation Sequencing Detects Pathogens in Endophthalmitis Patients

Metagenomic Next-Generation Sequencing Detects Pathogens in Endophthalmitis Patients

Paediatric endophthalmitis: a 10-year retrospective study at Hospital Kuala Lumpur for incidence, risk factors, and outcomes

Clinical Features, Antibiotic Susceptibilities, and Outcomes of Endophthalmitis Caused by Streptococcal Infection: Children vs. Adults

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