Vaibhavi Subhedar1, Neelam Bharihoke2, Praveen Singh3, Poonam Gupta4, Sudhir Kumar Jain5, Kiran Chaturvedi6
ABSTRACT: CONTEXT: Endopthalmitis is a microbial infection of the anterior and posterior segments of the eye following a surgical procedure traumatic penetrating injury or of endogenous origin. The visual prognosis depends widely on the timely identification of the infectious agent and the appropriate treatment. Here we present a study of 63 patients in which the incidence of endopthalmitis, spectrum of microorganisms and antibiotic susceptibility of bacterial isolates. Aims: To study the incidence, spectrum and antibiotic sensitivity pattern of bacterial isolates, to study the outcome of visual acuity post treatment and importance of microbiological diagnosis in treatment of microbial endopthalmitis. SETTINGS AND DESIGN: This study was carried out in the Dept of Microbiology Bombay hospital Indore. Aqueous and vitreous samples were collected aseptically by the retina specialist before injections of intravitreous antibiotics and were immediately transported to our lab for microbiological diagnosis. A total of 63 cases of endopthalmitis were studied from January 2013 to May 2014. METHODS AND MATERIAL: The samples were immediately cultured on BA, MA and SDA with chloramphenicol. Microscopy was done with centrifuged deposit. Antibiotic sensitivity test was performed for bacterial isolates by Kirby-Baurer’s disc diffusion method. Clinical history of the patients was collected from the retina speciality centre. Statistical analysis used: Standard method for prevalence. RESULTS: Out of the total 63 cases of endopthalmitis 44(69.8%) developed infection post operatively, 13(20.63%) developed due to trauma and 6(9.5%) developed endogenously. Maximum patients 34(53.96%) presented symptoms within one week of exposure. The Grams stain of 59 out of 63 showed either pus cells or organisms or both of which 39 were culture positive 4 cases of which were positive for fungus. Out of the total 39 specimens showing growth 12(30.7%) were Staphylococcus aureus, 10(25.64%) were Streptococcus pneumoniae 4(10.25%) each were Klebsiella pneumoniae and Pseudomonas and 3(7.6%) were Actinomyces, Branhamella and a member of non-fermenter 1 each (2.56%). 4 fungi included, 1candida albicans, 1 Aspergillus niger and 2 cases of Fusarium sp. CONCLUSIONS: In our study out of total 63 specimens 35 showed bacterial growth, while 4 showed fungal growth. Preliminary report of microscopy which was informed to the treating ophthalmic surgeon was very helpful for prompt treatment of the infected cases. 20 patients had good improvement in visual acuity post treatment.
