Pediatric Infectious Endophthalmitis: A 271-case Retrospective Study at a Single Center in China / 中华医学杂志(英文版)
Chinese Medical Journal
; (24): 2936-2943, 2016.
Article
de En
| WPRIM
| ID: wpr-230850
Bibliothèque responsable:
WPRO
ABSTRACT
<p><b>BACKGROUND</b>Pediatric infectious endophthalmitis is a serious sight-threatening disease for children. The purpose of this study was to investigate the etiology, microbiological spectrum, and visual outcomes of infectious endophthalmitis in children at a single institution in China.</p><p><b>METHODS</b>It is a retrospective study of the medical records of all patients under 14 years of age with histories of infectious endophthalmitis, treated at a single institution from January 1, 2009 to January 1, 2015. The clinical characteristics, etiology, microbiological spectrum, and management, as well as the visual outcomes, were analyzed. The Kappa test and Chi-square test were used in the statistical evaluation.</p><p><b>RESULTS</b>A total of 271 children were identified, with a mean age of 5.61 ± 2.93 years (range 5 months to 14 years). Ocular trauma (94.8%) and previous ocular surgery (3.0%) were the most common etiologies. Overall, 147 (54.2%) cases had positive cultures, and 176 organisms were isolated from these patients. A single species was isolated in 120 (81.6%) cases, with multiple organisms in 27 (18.4%) cases, and the most commonly identified organisms were coagulase-negative Staphylococcus and Streptococcus species, comprising 29.5% and 26.8% of the isolates, respectively. Moreover, of 176 isolates, 142 (80.8%) were Gram-positive organisms, 23 (13.0%) were Gram-negative organisms, and 11 (6.2%) were fungi. The final visual outcomes were 20/200 or better in 66 (24.4%) eyes, counting fingers to 20/200 in 34 (12.5%), hand motions in 30 (11.1%), light perception in 33 (12.2%), no light perception in 32 (11.8%), and 9 (3.3%) eyes were enucleated or eviscerated. The visual outcomes were not available in 67 (24.7%) patients.</p><p><b>CONCLUSIONS</b>Penetrating ocular trauma is the most frequent cause of pediatric endophthalmitis in China. Streptococcus and Staphylococcus species are the most commonly identified organisms in exogenous pediatric endophthalmitis whereas Fusarium species are commonly seen in endogenous endophthalmitis. In this research, in spite of aggressive management with antibiotics and vitrectomy, the visual prognosis was found to be generally poor.</p>
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Anatomopathologie
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Rétine
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Staphylococcus
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Streptococcus
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Virulence
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Vitrectomie
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Mycoses oculaires
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Plaies pénétrantes de l'oeil
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Chine
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Endophtalmie
Type d'étude:
Observational_studies
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Prognostic_studies
Limites du sujet:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
Pays comme sujet:
Asia
langue:
En
Texte intégral:
Chinese Medical Journal
Année:
2016
Type:
Article