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Clinical and microbiological profile of non-tuberculous mycobacterial endophthalmitis—experience in a tertiary eye care centre in Southern India

BACKGROUND: Endophthalmitis caused by non-tuberculous mycobacteria (NTM) is a rare condition seen after surgery and trauma. This study reports a retrospective, consecutive, non-comparative case series of 5 patients referred to L. V. Prasad Eye Institute, Hyderabad, and diagnosed with culture-proven...

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Autores principales: Paulose, Remya Mareen, Joseph, Joveeta, Narayanan, Raja, Sharma, Savitri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4954794/
https://www.ncbi.nlm.nih.gov/pubmed/27439781
http://dx.doi.org/10.1186/s12348-016-0096-x
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author Paulose, Remya Mareen
Joseph, Joveeta
Narayanan, Raja
Sharma, Savitri
author_facet Paulose, Remya Mareen
Joseph, Joveeta
Narayanan, Raja
Sharma, Savitri
author_sort Paulose, Remya Mareen
collection PubMed
description BACKGROUND: Endophthalmitis caused by non-tuberculous mycobacteria (NTM) is a rare condition seen after surgery and trauma. This study reports a retrospective, consecutive, non-comparative case series of 5 patients referred to L. V. Prasad Eye Institute, Hyderabad, and diagnosed with culture-proven NTM endophthalmitis between January 2004 and April 2015. Data collected included demographic information, presenting features, microbiology investigation, treatment course, and final visual outcome. RESULTS: Of 5555 clinically diagnosed infective endophthalmitis patients, vitreous samples were culture positive for bacteria in 1541 (27.7 %). The isolates from five (0.32 %) patients were identified as NTM. The clinical settings included post-cataract surgery (n = 3), post-vitrectomy (n = 1), and Descemet’s stripping endothelial keratoplasty (n = 1). The species of NTM identified were Mycobacterium chelonae (n = 3), Mycobacterium manitobense (n = 1), and Mycobacterium fortuitum (n = 1). All isolates were sensitive to amikacin while three of the five isolates were sensitive to vancomycin. Initial treatment strategies included pars plana vitrectomy with intravitreal antibiotic (vancomycin and amikacin) injection (n = 3), additional intraocular lens explant (n = 1), and silicone oil removal in the patient with post-vitreo-retinal surgery. Intravitreal steroid along with antibiotics were given in three patients. Final outcome was favourable (20/200) in one patient, two eyes had unfavourable outcome with multiple recurrences, one was advised evisceration, and one resulted in phthisis bulbi. CONCLUSIONS: This communication reports a series of five cases of NTM endophthalmitis. Poor outcome despite cultureguided therapy suggests virulent nature of the organisms and the need for better treatment strategies.
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spelling pubmed-49547942016-08-01 Clinical and microbiological profile of non-tuberculous mycobacterial endophthalmitis—experience in a tertiary eye care centre in Southern India Paulose, Remya Mareen Joseph, Joveeta Narayanan, Raja Sharma, Savitri J Ophthalmic Inflamm Infect Original Research BACKGROUND: Endophthalmitis caused by non-tuberculous mycobacteria (NTM) is a rare condition seen after surgery and trauma. This study reports a retrospective, consecutive, non-comparative case series of 5 patients referred to L. V. Prasad Eye Institute, Hyderabad, and diagnosed with culture-proven NTM endophthalmitis between January 2004 and April 2015. Data collected included demographic information, presenting features, microbiology investigation, treatment course, and final visual outcome. RESULTS: Of 5555 clinically diagnosed infective endophthalmitis patients, vitreous samples were culture positive for bacteria in 1541 (27.7 %). The isolates from five (0.32 %) patients were identified as NTM. The clinical settings included post-cataract surgery (n = 3), post-vitrectomy (n = 1), and Descemet’s stripping endothelial keratoplasty (n = 1). The species of NTM identified were Mycobacterium chelonae (n = 3), Mycobacterium manitobense (n = 1), and Mycobacterium fortuitum (n = 1). All isolates were sensitive to amikacin while three of the five isolates were sensitive to vancomycin. Initial treatment strategies included pars plana vitrectomy with intravitreal antibiotic (vancomycin and amikacin) injection (n = 3), additional intraocular lens explant (n = 1), and silicone oil removal in the patient with post-vitreo-retinal surgery. Intravitreal steroid along with antibiotics were given in three patients. Final outcome was favourable (20/200) in one patient, two eyes had unfavourable outcome with multiple recurrences, one was advised evisceration, and one resulted in phthisis bulbi. CONCLUSIONS: This communication reports a series of five cases of NTM endophthalmitis. Poor outcome despite cultureguided therapy suggests virulent nature of the organisms and the need for better treatment strategies. Springer Berlin Heidelberg 2016-07-20 /pmc/articles/PMC4954794/ /pubmed/27439781 http://dx.doi.org/10.1186/s12348-016-0096-x Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Paulose, Remya Mareen
Joseph, Joveeta
Narayanan, Raja
Sharma, Savitri
Clinical and microbiological profile of non-tuberculous mycobacterial endophthalmitis—experience in a tertiary eye care centre in Southern India
title Clinical and microbiological profile of non-tuberculous mycobacterial endophthalmitis—experience in a tertiary eye care centre in Southern India
title_full Clinical and microbiological profile of non-tuberculous mycobacterial endophthalmitis—experience in a tertiary eye care centre in Southern India
title_fullStr Clinical and microbiological profile of non-tuberculous mycobacterial endophthalmitis—experience in a tertiary eye care centre in Southern India
title_full_unstemmed Clinical and microbiological profile of non-tuberculous mycobacterial endophthalmitis—experience in a tertiary eye care centre in Southern India
title_short Clinical and microbiological profile of non-tuberculous mycobacterial endophthalmitis—experience in a tertiary eye care centre in Southern India
title_sort clinical and microbiological profile of non-tuberculous mycobacterial endophthalmitis—experience in a tertiary eye care centre in southern india
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4954794/
https://www.ncbi.nlm.nih.gov/pubmed/27439781
http://dx.doi.org/10.1186/s12348-016-0096-x
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