Recurrent Endophthalmitis Caused by Achromobacter xylosoxidans: Importance of Aggressive Surgical Removal of Capsular Bag

Park, Joong Hyun; Lee, Eun Kyoung; Lee, Sang Yoon; Kim, Dong Yoon; Kim, Jin Young

doi:10.3341/kjo.2017.0143

Cited by 4 publications

(16 citation statements)

References 4 publications

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“…Available data from case reports and small case series suggest that surgical management of chronic Achromobacter xylosoxidans endophthalmitis, including IOL and capsular bag removal, is critical to achieve resolution of the infection as a result of biofilm formation. 3 , 4 , 12 This is consistent with management recommendations for chronic postoperative endophthalmitis caused by other organisms. 1 In this case, the corneal graft was removed in addition to the IOL and capsule complex.…”

Section: Discussionsupporting

confidence: 82%

“…Chronic A. xylosoxidans endophthalmitis most often occurs after cataract surgery 3 , 4 , 12 and has never been reported as a complication of infectious keratitis. The patient’s most recent ophthalmic surgery was penetrating keratoplasty, and his graft had remained clear for five months without evidence of infection, suggesting the infection was unlikely to be related to the surgery, though donor rim cultures were not available.…”

Section: Discussionmentioning

confidence: 99%

“…xylosoxidans endophthalmitis case series have demonstrated that intraocular antibiotics alone are often insufficient and that removal of the IOL and lens capsule are frequently needed to achieve resolution of the infection. 3,4 The current report describes a patient with chronic A. xylosoxidans endophthalmitis who had undergone pars plana vitrectomy and an anterior chamber washout without resolution of infection, whose infection finally resolved after repeated PKP, removal of his IOL and capsular bag.…”

Section: Introductionmentioning

confidence: 96%

“…1 Achromobacter xylosoxidans is a motile gram-negative rod causing endophthalmitis either acutely or chronically, up to 5 years postoperatively. [2][3][4][5] A.…”

Section: Introductionmentioning

confidence: 99%

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Chronic, Recurrent Bacterial Endophthalmitis Caused by Achromobacter xylosoxidans: Clinical Features and Management

Lazzarini

Al-Khersan

Patel

et al. 2020

IMCRJ

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A 79-year-old man presented to a tertiary referral center from the Dominican Republic with an opaque corneal graft and a diagnosis of chronic, recurrent culture-positive Achromobacter xylosoxidans endophthalmitis of the left eye. The patient had a history of penetrating keratoplasty for Fuchs’ dystrophy and had undergone multiple intraocular surgeries including pars plana vitrectomy and anterior chamber wash out for the diagnosis and management of chronic endophthalmitis. After being referred, the patient underwent a third PKP, removal of his intraocular lens (IOL), capsulectomy, and injection of intravitreal antibiotics. All surgical specimens demonstrated the growth of A. xylosoxidans . Five months after surgery, the graft remained clear without evidence of infection and best-corrected visual acuity was 20/350.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

“…1 Achromobacter xylosoxidans is a motile gram-negative rod causing endophthalmitis either acutely or chronically, up to 5 years postoperatively. [2][3][4][5] A.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Chronic, Recurrent Bacterial Endophthalmitis Caused by Achromobacter xylosoxidans: Clinical Features and Management

Lazzarini

Al-Khersan

Patel

et al. 2020

IMCRJ

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“…Achromobacter xylosoxidans displayed a notable treatment process compared to the other pathogens detected in our study. Few cases of severe recurrent endophthalmitis caused by Achromobacter xylosoxidans have been reported [ 43 ]. Owing to the characteristics of Achromobacter xylosoxidans in creating a biofilm, and remaining in the capsular bag and intraocular lens, a high tendency of recurrence was observed despite simple pars plana vitrectomy and intravitreal antibiotic injections [ 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Atypical Microbiological Feature of Infectious Endophthalmitis on Jeju Island: A 10-Year Study at a Single Tertiary Referral Center

Park

Kim

et al. 2021

Journal of Ophthalmology

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Background. To analyze the microbiological causes of infectious endophthalmitis on an isolated island over ten years. Methods. A retrospective review of the medical records of 49 eyes clinically diagnosed with infectious endophthalmitis between January 2009 and December 2018 was done. The subjects were recruited from a single tertiary referral center on Jeju Island. The baseline characteristics of all subjects were investigated, and a culture examination was performed. The isolated pathogens were analyzed to determine how their microbiological features differed from those in regions with different geographical conditions. Results. Of the 49 eyes, causative microorganisms were identified in 27 eyes (55.1%). Bacteria were found in 24 cases and fungi in 3 cases. Among the exogenous causes, Staphylococcus species (Staphylococcus aureus, S. epidermidis, and S. hominis) were the most common pathogens (7 cases). Achromobacter xylosoxidans was the second most common causative pathogen (4 cases) followed by Moraxella species (3 cases). The most frequent endogenous origin was due to Klebsiella pneumoniae (6 cases). The subjects were divided into two groups according to the treatment results and analyzed for predisposing factors related to visual outcomes. The presence of diabetes mellitus ( P = 0.038) and initial visual acuity ( P ≤ 0.001) were significant predisposing factors for visual outcomes. Conclusion. The causative microorganisms of endogenous endophthalmitis on Jeju Island were not different from those reported previously. However, isolated exogenous microorganisms were different from those reported in other studies from inland areas. A high incidence and atypical clinical features of Achromobacter xylosoxidans and Moraxella in exogenous endophthalmitis were observed, reflective of the distinct climatic features of Jeju Island: high humidity and temperature. Therefore, considering the causative microorganisms of exogenous endophthalmitis, it may be assumed that the causative microorganisms of exogenous endophthalmitis and its clinical manifestations differ according to the region.

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Achromobacter xylosoxidans as emerging pathogen in healthcare settings: A mini review

Cano

Silva-Rojas

2023

Narra X

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Microorganisms of the genus Achromobacter have been mentioned as a cause of opportunistic infections, mainly in patients with cystic fibrosis or pulmonary lymphoma, with the species Achromobacter xylosoxidans being identified to a large extent. A. xylosoxidans was first described in 1971 and is an opportunistic pathogen. However, it been reported to cause chronic purulent otitis, meningitis, pneumonia, peritonitis and urinary tract infections, chronic obstructive pulmonary disease and other infections. The present literature review aims to analyze and synthesize the state of the art on A. xylosoxidans and its potential as an emerging pathogen in the healthcare settings. We discuss A. xylosoxidans as an emerging opportunistic pathogen that is associated with healthcare infections. This review further discusses the prevalence of A. xylosoxidans in healthcare settings, the types of infections it can cause, and the risk factors for acquiring an A. xylosoxidans infection. The review also covers the challenges in treating A. xylosoxidans infections, including its potential for drug resistance and the lack of specific treatments. Strategies for preventing and controlling A. xylosoxidans infections in healthcare settings were also discussed.

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Recurrent Endophthalmitis Caused by Achromobacter xylosoxidans: Importance of Aggressive Surgical Removal of Capsular Bag

Cited by 4 publications

References 4 publications

<p>Chronic, Recurrent Bacterial Endophthalmitis Caused by <em>Achromobacter xylosoxidans</em>: Clinical Features and Management</p>

<p>Chronic, Recurrent Bacterial Endophthalmitis Caused by <em>Achromobacter xylosoxidans</em>: Clinical Features and Management</p>

Atypical Microbiological Feature of Infectious Endophthalmitis on Jeju Island: A 10-Year Study at a Single Tertiary Referral Center

Achromobacter xylosoxidans as emerging pathogen in healthcare settings: A mini review

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