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Ophthalmologica. 2019;241(4):211-219. doi: 10.1159/000496942. Epub 2019 Mar 19.

Causative Pathogens of Endophthalmitis after Intravitreal Anti-VEGF Injection: An International Multicenter Study.

Author information

1
Charité - University Medicine Berlin, Berlin, Germany.
2
Berlin Institute of Health, Berlin, Germany.
3
Department of Ophthalmology, University of Leipzig, Leipzig, Germany.
4
Private Retina Service, University of Buenos Aires, Buenos Aires, Argentina.
5
Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
6
Department of Ophthalmology, University Hospital Dijon, Dijon, France.
7
Eye and Nutrition Research Group, Centre des Sciences du Goût et de l'Alimentation, UMR1324 INRA, 6265 CNRS, University of Bourgogne Franche-Comté, Dijon, France.
8
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
9
Faculty of Medicine, Favaloro University, Buenos Aires, Argentina.
10
Department of Ophthalmology, Faculty of Medicine, Rajavithi Hospital, Rangsit University, Bangkok, Thailand.
11
Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
12
Retina Division, Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
13
Service d'Ophtalmologie, Hôpital Lariboisière, AP-HP, Université Paris 7 - Sorbonne Paris Cité, Paris, France.
14
Department of Ophthalmology, Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia.
15
Australian School of Advanced Medicine, Macquarie University, Sydney, New South Wales, Australia.
16
Westmead Hospital, Sydney, New South Wales, Australia.
17
St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.
18
Department of Applied Medical-Surgical Sciences, Tor Vergata University, Rome, Italy.
19
Department of Ophthalmology, Pauls Stradins Clinical University Hospital, Riga, Latvia.
20
Centro Hospitalar e Universitário de Coimbra, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
21
Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.
22
Department of Biomedical and Surgical Sciences, Section of Ophthalmology, University of Perugia, Perugia, Italy.
23
Department of General Ophthalmology, Medical University in Lublin, Lublin, Poland.
24
Institut Clínic d'Oftalmologia (ICOF), Hospital Clínic de Barcelona, Barcelona, Spain.
25
Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
26
Incumbent, Sydney A. Fox chair in Ophthalmology, Tel Aviv University, Tel Aviv, Israel.
27
Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, dinahzur@gmail.com.

Abstract

PURPOSE:

The main objective of this study was to investigate the microbiological spectrum of endophthalmitis after anti-VEGF injections and to compare streptococcal with non-streptococcus-associated cases with regard to baseline characteristics and injection procedure.

METHODS:

Retrospective, international multicenter study of patients with culture-positive endophthalmitis after intravitreal anti-VEGF injection at 17 different retina referral centers.

RESULTS:

Eighty-three cases with 87 identified pathogens were included. Coagulase-negative staphylococci (59%) and viridans streptococci (15%) were the most frequent pathogens found. The use of postoperative antibiotics and performance of injections in an operating room setting significantly reduced the rate of streptococcus-induced endophthalmitis cases (p = 0.01 for both).

CONCLUSION:

We found a statistically significant lower rate of postinjectional local antibiotic therapy and operating room-based procedures among the streptococcus-induced cases compared to cases caused by other organisms.

KEYWORDS:

Endophthalmitis; Intravitreal injection; Vascular endothelial growth factor

PMID:
30889590
DOI:
10.1159/000496942
[Indexed for MEDLINE]

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