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Comparative Study
. 2016 Nov 25;16(1):706.
doi: 10.1186/s12879-016-2038-5.

Comparison of the most common isolates of postoperative endophthalmitis in South Korea; Enterococcus species vs coagulase-negative staphylococci

Ki Yup Nam  1 , Hyun Wong Kim  2 , Woo Jin Jeung  3 , Jung Min Park  4 , Jong Moon Park  5 , In Young Chung  5 , Yong Seop Han  5 , Bu Sup Oum  6 , Ji Eun Lee  7 , Ik Soo Byon  7 , Il Han Yun  8 , Joo Eun Lee  2 , Hee Sung Yoon  9 , Dong Park  10 , Byeng Chul Yu  11 , Sang Joon Lee  12   13
Affiliations
Comparative Study

Comparison of the most common isolates of postoperative endophthalmitis in South Korea; Enterococcus species vs coagulase-negative staphylococci

Ki Yup Nam et al. BMC Infect Dis. .

Abstract

Background: To compare the related factors or manifestations of the two most common isolates of post-operative endophthalmitis, which were Enterococcus spp. and coagulase-negative staphylococci (CNS) in South Korea.

Methods: Medical records were reviewed for cases of post-operative endophthalmitis caused by Enterococcus spp. and CNS at eight institutions between January 2004 and July 2010. Various factors including age, sex, residence, systemic diseases, smoking and drinking history, and best corrected visual acuity, and length of time between causative intraocular surgery and symptom development were compared between the two groups.

Results: The total number of post-operative endophthalmitis cases was 128 and in 116 cases, microbiological culture tests from the aqueous humor or vitreous were performed. Among these cases, 67 (57.8%) were culture proven. Among these 67 cases, 19 (28.4%) were caused by Enterococcus spp., 14 (20.9%) were caused by Staphylococcus epidermidis endophthalmitis, and 5 (7.5%) were caused by other CNS spp. Age, sex, causative procedure, past medical history, social history, and laterality were not different in the two groups. Mean initial and final visual acuity were significantly worse in the Enterococcus spp. endophthalmitis group than in the CNS group (p = 0.049, 0.042, respectively). Length of time between the causative procedure and symptom development was significantly shorter in cases of Enterococcus spp. endophthalmitis (p = 0.004).

Conclusions: Enterococcus spp. induce more severe and rapid-onset postoperative endophthalmitis than CNS. Infectious endophthalmitis developed within 2 days after cataract operation could be caused by Enterococcus spp. and have chance to be poor prognosis in South Korea.

Keywords: Coagulase negative staphylococci; Endogenous endophthalmitis; Endophthalmitis; Enterococcus faecalis; Postoperative endophthalmitis; Posttraumatic endophthalmitis; Staphylococcus epidermidis.

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Figures

Fig. 1
Fig. 1
Comparison of mean initial and final visual acuity in CNS and Enterococcus spp. Groups. a, b The initial visual acuities showed no significant difference between CNS and Enterococcus spp. group, but the final visual acuity were significantly worse in Enterococcus spp. (p = 0.02, t-test). c, d The subgroups of initial and final visual acuities showed that the number of patients who were between 5/200 and NLP were significantly more in the Enterococcus spp. group (p = 0.049, Fisher’s exact test). e, f Vitrectomy as a initial treatment could not change the pattern of initial and final visual acuity of the Enterococcus spp. group
Fig. 2
Fig. 2
Duration from causative procedure to symptom development. a Mean duration from causative procedure to symptom development, b Distribution chart of symptom development duration (p < 0.05)
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