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Abstract #67594 Published in IGR 17-4
Endophthalmitis caused by Non-tuberculous Mycobacterium: Clinical features, Antimicrobial Susceptibilities and Treatment Outcomes
Shah M; Relhan N; Kuriyan AE; Davis JL; Albini TA; Pathengay A; Miller D; Flynn HWAmerican Journal of Ophthalmology 2016; 168: 150-156
PURPOSE: - To report the clinical features, antibiotic susceptibilities and treatment outcomes in patients with endophthalmitis caused by non-tuberculous mycobacterium. DESIGN: - Non-comparative, consecutive case series. METHODS: - Retrospective chart review between December 1990 and June 2014. RESULTS: - In the 19 study patients, the clinical setting of endophthalmitis included post-cataract surgery (7/19, 36.8%), post-glaucoma implant (6/19, 31.6%), post-intravitreal injection (2/19, 10.5%), endogenous endophthalmitis (2/19, 10.5%), post-pars plana vitrectomy (1/19, 5.3%) and post-scleral buckle exposure (1/19, 5.3%). Chronic recurrent or persisting ocular inflammation was present in 15/19 patients (78.9%). The species isolated were Mycobacterium chelonae in 14/19 (73.7%) patients, Mycobacterium fortuitum in 3/19 (15.8%) patients, Mycobacterium triplex in 1/19 (5.3%) patients and Mycobacterium avium intracellulare in 1/19 (5.3%) patients. Antibiotic susceptibilities to tested isolates were the following: amikacin 14/16 (87.5%) and clarithromycin 12/16 (75.0%). Intravitreal injections of amikacin (0.4mg/0.1ml) were given in 14/19 (73.7%) patients with an average of 7 injections per patient (range - 1-24 injections). Intraocular lens removal was performed for 6/7 (85.7%) patients with post-cataract surgery endophthalmitis. All the patients with glaucoma implant (6/6, 100%) underwent implant removal. At last follow-up, 6/19 (31.6%) patients had best corrected visual acuity of 20/400 or better. CONCLUSION: - Endophthalmitis caused by non-tuberculous mycobacterium often included chronic recurrent or persistent intraocular inflammation and frequently required removal of ocular device (intraocular lens, glaucoma implant or scleral buckle). The majority of the isolates were susceptible to amikacin and clarithromycin. Visual outcomes in these patients even after treatment were generally poor.
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Florida, USA.
Full articleClassification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)