Spectrum of pathogens involved in eye infections observed at a rural hospital
Location
Philadelphia, PA
Start Date
30-4-2025 1:00 PM
End Date
30-4-2025 4:00 PM
Description
Introduction: Infections of the eye and the surrounding structures may lead to serious complications including vision loss and death. In some cases, immediate intervention and aggressive treatment are necessary for preservation of vision. Globally, blindness and ocular morbidity continue to be a burden from bacterial infections with varying prevalence. In the United States, rates of antibiotic resistance continue to rise. The spectrum of pathogen involved in eye infections is quite diverse including bacteria and fungi. The cause of these infections varies regionally.
Objective: The primary objective of this study was to identify pathogens involved in eye and periorbital infections at a rural hospital in Maryland, USA.
Methods: Hospital database was searched for all patients presenting with infections of the eye which includes eyebrow, eyelid, and vitreous fluid during a 4-year period (September 2018 to December 2022).
Results: A total of 54 isolates from 44 patients (19 male/25 female) were identified. Nineteen percent were pediatric. Median BMI of the cohort was 29.1 (range 15.7-44.5) kg/m2. Of the specimens, 40 percent were labeled eye, 30 percent eyebrow/eyelid and 30 percent vitreous fluid. Thirty seven percent were sent by ophthalmologists with 36 percent from primary care physicians, 18 percent from ED, and 9 percent from other services. Abscesses and wounds accounted for 18 percent of specimens, 58 percent from fluid collections or tissue. Endophthalmitis was the most common clinical diagnosis (13 percent), and periorbital abscess and cellulitis accounted for 7 cases each. Microscopy of 41 specimens revealed WBC in 73 percent of specimens, Gram-positive cocci in 24 percent, Gram-negative rods 2 percent, and Yeast 2 percent. Staphylococci were cultured in 80 percent of the specimens, streptococci in 9 percent, enterococci in 2 percent, Gram-negative rods in 12 percent, anaerobes in 5 percent and Yeast in 2 percent (Candida dubliniensis). In one case, Neisseria gonorrhea was isolated. Staphylococcus aureus was the most common pathogen with 24 isolates of which 13 being Methicillin resistant. One patient had a mixed infection with Stenotrophomonas maltophilia and Achromobacter xylosoxidans
Conclusion: Consistent with prior studies, Staphalococcus aureus is a common cause of endophthalmitis and extra-vitreous infections. Knowledge of the spectrum of pathogens causing eye infections is crucial for choosing the correct antibiotics when initiating empiric therapy.
Embargo Period
5-19-2025
Spectrum of pathogens involved in eye infections observed at a rural hospital
Philadelphia, PA
Introduction: Infections of the eye and the surrounding structures may lead to serious complications including vision loss and death. In some cases, immediate intervention and aggressive treatment are necessary for preservation of vision. Globally, blindness and ocular morbidity continue to be a burden from bacterial infections with varying prevalence. In the United States, rates of antibiotic resistance continue to rise. The spectrum of pathogen involved in eye infections is quite diverse including bacteria and fungi. The cause of these infections varies regionally.
Objective: The primary objective of this study was to identify pathogens involved in eye and periorbital infections at a rural hospital in Maryland, USA.
Methods: Hospital database was searched for all patients presenting with infections of the eye which includes eyebrow, eyelid, and vitreous fluid during a 4-year period (September 2018 to December 2022).
Results: A total of 54 isolates from 44 patients (19 male/25 female) were identified. Nineteen percent were pediatric. Median BMI of the cohort was 29.1 (range 15.7-44.5) kg/m2. Of the specimens, 40 percent were labeled eye, 30 percent eyebrow/eyelid and 30 percent vitreous fluid. Thirty seven percent were sent by ophthalmologists with 36 percent from primary care physicians, 18 percent from ED, and 9 percent from other services. Abscesses and wounds accounted for 18 percent of specimens, 58 percent from fluid collections or tissue. Endophthalmitis was the most common clinical diagnosis (13 percent), and periorbital abscess and cellulitis accounted for 7 cases each. Microscopy of 41 specimens revealed WBC in 73 percent of specimens, Gram-positive cocci in 24 percent, Gram-negative rods 2 percent, and Yeast 2 percent. Staphylococci were cultured in 80 percent of the specimens, streptococci in 9 percent, enterococci in 2 percent, Gram-negative rods in 12 percent, anaerobes in 5 percent and Yeast in 2 percent (Candida dubliniensis). In one case, Neisseria gonorrhea was isolated. Staphylococcus aureus was the most common pathogen with 24 isolates of which 13 being Methicillin resistant. One patient had a mixed infection with Stenotrophomonas maltophilia and Achromobacter xylosoxidans
Conclusion: Consistent with prior studies, Staphalococcus aureus is a common cause of endophthalmitis and extra-vitreous infections. Knowledge of the spectrum of pathogens causing eye infections is crucial for choosing the correct antibiotics when initiating empiric therapy.