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Relationship between baseline clinical data and microbiologic spectrum in 100 patients with acute postcataract endophthalmitis

机译：100例急性白内障后眼内炎患者临床资料与微生物谱的关系

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Purpose: To correlate the initial ocular presentation with bacterial identification in 100 patients with acute postcataract endophthalmitis. Methods: This was a prospective multicenter study. Demographic data, medical history, and the initial eye examination data were recorded on a standardized form. The relationship between bacterial identification and clinical factors at baseline was studied using univariate and multivariate analyses. Results: One hundred patients were admitted to the hospital with a median delay of 6 days after cataract surgery. The main symptoms were loss of vision (94.9%) and pain (75.5%). Major clinical signs were hypopyon (72%), pupillary fibrin membrane (77.5%), and loss of fundus visibility (90%). Baseline factors significantly associated with microbiologic identification were as follows: diabetes mellitus, a shorter delay of onset, initial visual acuity limited to light perception, higher intraocular pressure, chemosis, pupillary fibrin membrane, loss of the red reflex, and reduced fundus visibility. As compared with other bacteria, the identification of Streptococcus species (n = 19) was more frequently associated with male gender, diabetes mellitus, initial visual acuity limited to light perception, and pain. The Staphylococcus aureus and Staphylococcus lugdunensis group (n = 14) differed from other coagulase-negative Staphylococcus groups (n = 33) in that those patients had greater hypopyon height. Conclusion: The baseline features of acute endophthalmitis after cataract surgery in the era of phacoemulsification are similar to those reported in the Endophthalmitis Vitrectomy Study 15 years ago and differ according to the bacterial species. The association between the clinical signs and the microbiologic identification suggests that initial characteristics other than visual acuity may be useful in identifying patients presumed to be infected with a virulent species.
机译：目的：将100例急性白内障后眼内炎患者的初始眼部表现与细菌鉴定相关联。方法：这是一项前瞻性多中心研究。人口统计数据，病史和最初的眼科检查数据以标准化形式记录。使用单变量和多变量分析研究了基线时细菌鉴定与临床因素之间的关系。结果：白内障手术后100例患者入院，平均延迟6天。主要症状是视力丧失（94.9％）和疼痛（75.5％）。主要的临床体征为双眼震颤（72％），瞳孔纤维蛋白膜（77.5％）和眼底可见度丧失（90％）。与微生物学鉴定显着相关的基线因素如下：糖尿病，较短的发作延迟，仅限于光感知的初始视敏度，较高的眼内压，化学作用，瞳孔纤维蛋白膜，红色反射消失和眼底可见度降低。与其他细菌相比，链球菌种类（n = 19）的鉴定与男性，糖尿病，最初视敏度仅限于光感知和疼痛的频率更高。金黄色葡萄球菌和lugdunensis金黄色葡萄球菌组（n = 14）与其他凝固酶阴性金黄色葡萄球菌组（n = 33）的不同之处在于，这些患者的hypopyon高度更高。结论：在白内障超声乳化术时代，白内障手术后急性眼内炎的基线特征与15年前眼内膜玻璃体切除术研究中报道的特征相似，并且因细菌种类而异。临床体征与微生物学鉴定之间的关联表明，除了视敏度外，其他初始特征也可能有助于鉴定假定感染了强毒菌种的患者。

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