The clinical spectrum of endophthalmitis: incidence, predisposing factors, and features influencing outcome

Article Abstract:

Endophthalmitis is an inflammatory disease of the eye resulting from bacterial infection or ocular tissue trauma. Endophthalmitis most commonly occurs following eye surgery. Severe cases of endophthalmitis result in blindness. A survey of the medical records of all patients with a discharge diagnosis of endophthalmitis from one hospital between January 1980 and December 1985, was conducted to determine the predisposing factors and features that influence the development and treatment of endophthalmitis. Endophthalmitis was diagnosed in 114 patients, and the average annual incidence during the six-year study period was 4.75 cases per 10,000 discharges. The study group consisted of 114 patients with endophthalmitis, 96 percent were Caucasian and 53 percent were women. Of the 114 patients with endophthalmitis, 76 percent had undergone recent ocular surgery (cataract removal), and 11 percent had suffered ocular trauma. Seventy-five percent of the patients had bacterial infections. In 52 percent of the cases, endophthalmitis appeared within six days following surgery or exposure to trauma. The most common infective agent was Staphylococcus epidermidis, accounting for 47 percent of the postoperative infections and 60 percent of the trauma-related infections. Various strains of Staphylococcus and Streptococcus accounted for 73 percent of the total number of infections. Oxacillin, clindamycin and gentamicin were effective in treating 70 to 86 percent of the Staphylococcus infections. All of the strains of Staphylococcus were sensitive to vancomycin. Symptoms accompanying the endophthalmitis included headache, ocular pain, redness and reduced vision. Endophthalmitis was more common in the right eye (59.6 percent) than in the left eye (38.6). Very few cases involved both eyes (1.8 percent). It is concluded that vancomycin and gentamicin should be used in patients who develop endophthalmitis following surgery or ocular trauma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Development and progression, Drug therapy, Cataract, Cataract extraction, Eye, Eye surgery, Eye diseases, Endophthalmitis

---

A new semiquantitative culture method for early detection of surgical incisional wound infection

Article Abstract:

Unfortunately, after surgery there is a significant risk of developing an infection in the wound. About 7 percent of all surgical wounds are complicated by infection, making this the second largest source of nosocomial (hospital-acquired) infections. Although the surgical wound may be examined daily, there is usually no definite sign of infection until a purulent discharge develops at the site of infection. Although taking and culturing a tissue biopsy can demonstrate the existence of an infection, this technique is laborious and invasive. Since it would be beneficial to identify surgical wound infections earlier, prior to the development of a purulent discharge, a technique was developed which may identify an infection in the early stages while at the same time being straightforward and easy to perform. The technique involves the insertion of a 20-gauge plastic catheter into the inflamed area of the wound. If any material can be aspirated, it is stained for microscopy. Upon removal from the wound, the plastic catheter is cut with a scalpel and placed on an agar plate; agar is a medium in which bacteria grow readily and can be identified. The catheter is rolled back and forth across the plate before being itself buried into the agar in the center. In the evaluation of this method, 44 of 53 wounds studied revealed either no bacteria or small amounts indicative of superficial contamination and not wound infection. None of these 44 wounds developed infection. Conversely, all nine of the remaining wounds, which showed more than 15 separate foci of bacteria growing on the agar plate, ultimately developed a purulent discharge. The culture of the discharge recovered the same infectious organism which had previously been recovered from the agar plate. This method appears to be tremendously useful for predicting the development of postsurgical wound infection and identifying the infectious organism involved. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Diagnosis, Nosocomial infections, Cross infection

---

A common-source outbreak of staphylococcus epidermidis among patients undergoing cardiac surgery

Article Abstract:

Patients who have recently undergone heart surgery are at risk for developing postoperative infections, particularly endocarditis from prosthetic valves and surgical wound infections. Staphylococcus epidermidis is a type of bacteria that has been responsible for postoperative epidemics in patients who have had cardiac surgery. The source of one epidemic of postoperative Staphylococcus epidermidis infection was traced to the hands of the operating surgeon. It seemed that a single strain of Staphylococcus epidermidis was responsible for an outbreak of postoperative endocarditis and wound infections. The infections appeared more often when one particular surgeon (surgeon A) performed the cardiac surgery. It seemed that only those patients having surgery performed by surgeon A developed the Staphylococcus epidermis wound infections at the sternum (chest bone) and on artificial valves. Since surgeon A was not responsible for removing saphenous veins in the legs, which are used for bypass grafting, none of the donor sites were infected with the bacteria. The 17 members of the surgical team were tested for the bacteria by culturing the nose, underarms, and groin area. The patients and other environmental sources were investigated and cleared. Hand cultures were performed on eight surgical personnel. The specific Staphylococcus epidermis strain of bacteria found in the infected cardiac patients and in the bypass pump matched the bacteria found on the hands of surgeon A. How the surgeon was able to transfer the bacteria during surgery was not ascertained. Small perforations in surgical gloves have been reported elsewhere. The surgeon recently began using sterile mineral oil on his hands, which might have promoted the bacterial growth. An effective antimicrobial soap scrub used prior to surgery to rid the surgeon's hands of any bacteria eliminated any further contamination. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Causes of, Endocarditis, Bacterial, Bacterial endocarditis, Staphylococcal infections

Similar abstracts:

• Abstracts: The perinatal impact of cocaine, amphetamine, and opiate use detected by universal intrapartum screening
• Abstracts: Clinical predictors of Chlamydia trachomatis endocervicitis in adolescent women: looking for the right combination
• Abstracts: Nutrition and the incidence of stress fractures in ballet dancers. part 2 A comparative review of the risks and benefits of hormone replacement therapy regimens
• Abstracts: Widespread silent transmission of pertussis in families: antibody correlates of infection and symptomatology. Pertussis and its prevention: a family affair

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.