ceoti

Clinical and Experimental Ocular Trauma and Infection

2667-8462

Sertaç Argun KIVANÇ

Ophthalmology

Göz Hastalıkları

Emerging culprit of post-operative cluster endophthalmitis in Eastern India: Acinetobacter baumannii

https://orcid.org/0000-0003-3438-0040

Nishant

Prateek

Akhand Jyoti Eye Hospital

https://orcid.org/0000-0002-3764-7321

Kumar

Roshan

All India Institute of Medical Sciences

https://orcid.org/0000-0003-2064-1131

Sadhukhan

Kaushik

All India Institute of Medical Sciences

https://orcid.org/0009-0000-6011-2803

Nanda

Jayadev

All India Institute of Medical Sciences

https://orcid.org/0000-0002-6133-5977

Sinha

Sony

All India Institute of Medical Sciences

12 31 2024

6 1 6 10 04 25 2024 12 30 2024

2019

Clinical and Experimental Ocular Trauma and Infection

Purpose: To report clinical profile, etiology, management, outcomes and drug sensitivity in Acinetobacter baumannii cluster endophthalmitis.Methods: Four post-surgical cases presented to a tertiary care hospital in eastern India 5 days after manual small incision cataract surgery - two were diabetic with unilateral panophthalmitis and no light perception and two had no systemic diseases, unilateral endophthalmitis with perception of light only. All cases underwent immediate core vitrectomy with intravitreal antibiotics followed by repeat intravitreal antibiotics and anterior chamber wash.Results: A. baumannii sensitive to amikacin was isolated from vitreous in all cases. One patient achieved vision of 6/60, while one patient retained 1/60 vision with clear media and attached retina at final visit. Two eyes with panophthalmitis ended up with phthisis bulbi.Conclusion: A. baumannii is a very rare cause of common source endophthalmitis with poor visual and anatomical outcomes. Prevention through rigorous pre-operative preparation cannot be overemphasized

Vision loss Epidemic Intraocular surgery Vitrectomy Infection edophthalmitis

All India Institute of Medical Sciences, Patna

1.Durand ML. Endophthalmitis. Clin Microbiol Infect.2013;19:227-34.

2.Porwal AC. Patel A, Mathew BC, Jethani JN. Incidence of postoperative endophthalmitis with and without use of intracameral moxifloxacin. Indian Journal of Ophthalmology.2021;69:1353-4.

3.Verma L, Chakravarti A. Prevention and management of postoperative endophthalmitis: A case-based approach. Indian J Ophthalmol. 2017;65:1396-1402.

4.Chakrabarti A, Shivaprakash MR, Singh R, Tarai B, George V, Fomda B, Gupta A. Fungal Endophthalmitis: Fourteen Years’ Experience From a Center in India. Retina 2008;28:1400-7.

5.Rathi R, Rana R, Nema N, Maurya R P, Gaur N, Jain A, Patel S, Verma A, Subedar V, Cataract surgery clinical features, treatment and operational difficulties in management of cluster endophthalmitis. Indian J Clin Exp Ophthalmol.2024;10:37-44.

6.Roy R, Panigrahi P, Malathi J, Pal SS, Nandi K, Patil A, Nigam E, Arora V. Endophthalmitis caused by Acinetobacter baumanni: a case series. Eye (Lond). 2013;27:450-2.

7.Singh K, Misbah A, Saluja P, Singh AK. Review of manual small-incision cataract surgery. Indian J Ophthalmol. 2017;65:1281-8.

8.Parvaresh MM, Mehrpouya AA, Ganji Anari R, Aghamirsalim M, Abri Aghdam K, Ghasemi Falavarjani K. Endophthalmitis caused by Acinetobacter spp. as the presenting manifestation of diabetes mellitus. J Curr Ophthalmol.2016;28:152-4.

9.Bitirgen G, Ozkagnici A, Kerimoglu H, Kamis U. Acute postoperative endophthalmitis with an unusual infective agent: Acinetobacter baumannii. J Cataract Refract Surg. 2013;39:143-4.

10.Feng HL, Robbins CB, Fekrat S. A Nine-Year Analysis of Practice Patterns, Microbiologic Yield, and Clinical Outcomes in Cases of Presumed Infectious Endophthalmitis. Ophthalmol Retina. 2020;4(6):555-9.

11.Moisseiev E, Abbassi S, Park SS. Intravitreal Dexamethasone in the Management of Acute Endophthalmitis: A Comparative Retrospective Study. European Journal of Ophthalmology. 2017;27:67-73.

12.Chen KJ, Hou CH, Sun MH, Lai CC, Sun CC, Hsiao CH. Endophthalmitis caused by Acinetobacter baumannii: report of two cases. J Clin Microbiol. 2008;46:1148-50.

13.Cornut PL, Chiquet C. Injections intravitréennes d'antibiotiques et endophtalmies [Intravitreal injection of antibiotics in endophthalmitis]. J Fr Ophtalmol.2008;31:815-23.

14.Doft BH, Wisniewski SR, Kelsey SF, Fitzgerald SG; Endophthalmitis Vitrectomy Study Group. Diabetes and postoperative endophthalmitis in the endophthalmitis vitrectomy study. Arch Ophthalmol. 2001;119:650-6.