Post-Traumatic Endophthalmitis: Clinico-Microbiological Profile, Antimicrobial Susceptibility and Prognostic Factors at a Tertiary Eye Care Centre in Eastern India

ABSTRACT

Purpose: To analyse clinico-microbiological profile, antimicrobial susceptibilities, and visual prognostic factors in post-traumatic endophthalmitis (PTE).

Methods: Retrospective clinico-microbiological data analysis for five years (2014–18). Prognostic factors for visual outcomes were analysed by multivariate logistic regression analysis.

Results: Four hundred and eighteen patients with clinically diagnosed PTE were analysed. Culture positivity was found in 46.7% samples (44.5% vitreous, 83.3% non-vitreous). Pathogens isolated were Gram positive cocci (GPC, 49.3%, good susceptibility to vancomycin/cefazolin), Gram negative bacilli (GNB, 28.1%, <90% susceptibility to all antibiotics and 25.8% multidrug resistance), Gram positive bacilli (13.1%) and fungi (9.5%). Poor visual prognosis was associated with culture positivity, fungal or polymicrobial PTE, poor view of fundus and presence of membranes on ultrasound scans.

Conclusion: GPC and GNB are the predominant pathogens in PTE, with GNB most commonly multidrug resistant. Culture positivity, polymicrobial and fungal PTE, poor view of fundus and vitreous membranes are markers of poor visual outcome.

KEYWORDS:

• Post-traumatic endophthalmitis
• Gram negative endophthalmitis
• Ocular pathogens
• Antimicrobial susceptibilities
• Visual prognostic factors

ACKNOWLEDGMENTS

Dr. Taraprasad Das and Dr. Savitri Sharma for their intellectual support in preparing the manuscript; Aparajita Mallick, Manas Ranjan Barik and Shilpa Priyadarshini for help in microbiology data collection.

AUTHOR CONTRIBUTION

1. Sanchita Mitra: conceptual design, intellectual contribution, data collection, data analysis, manuscript writing

2. Tushar Aggarwal: data analysis, manuscript writing

3. Abhijit Naik- data collection, manuscript review

4. Tapas Ranjan Padhi: intellectual contribution, manuscript review

5. Soumyava Basu- conceptual design, intellectual contribution, manuscript review

6. Umesh Chandra Behera: intellectual contribution, manuscript review• Data Availability: Data available with authors and can be shared if requested. We do not have any data repository.• Animal Research (Ethics): We have not conducted any animal research for this study.• Consent to Participate (Ethics): Written, informed consent was obtained from patients for any intervention and usage of their data for advancement of science.• Consent to Publish (Ethics): Institutional ethics committee clearance obtained for our study grants us permission to publish. We, authors, have agreed for publishing this study as well.

• Plant Reproducibility: We have not used any plants for our study.• Clinical Trials Registration: Our study does not categorize as a clinical trial.• Gels and Blots/ Image Manipulation: We do not have any gels or blots or any other images in our manuscript.

COMPETING INTERESTS

The authors report no competing interest for this work.

Additional information

Funding

This work was funded by Hyderabad Eye Research Foundation (HERF).