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Purpose: To study prospectively and compare the clinical and microbiological features and management outcomes in infectious endophthalmitis caused by biofilm positive and biofilm negative bacteria.
Prospective Comparison of Clinico-Microbiological Features And Management Outcomes In Infectious Endophthalmitis Caused By Biofilm Positive And Biofilm Negative Bacteria
Vivek Dave1, Dimple Lodha1, Roshni Karolia2, Savitri Sharma, MD2
1Smt. Kanuri Santhamma Center for Vitreoretinal diseases, LV Prasad Eye Institute;
2Jhaveri Microbiology Center, LV Prasad Eye Institute, Hyderabad, India
Methods: A prospective, observational, comparative, non-randomized, consecutive case series. All cases of endophthalmitis from 1st August 2018 to 31st July 2019 which were culture positive for bacteria were included in the study. All culture positive samples were tested in vitro for biofilm formation by crystal violet method and tetrazolium XTT salt method. Cases were classified as biofilm negative (BN) and biofilm positive (BP) group. Anatomic success was defined as globe salvage and functional success was defined as final vision >20/200.
Results: There were 50 eyes in the BN group and 33 eyes in the BP group. Mean age at presentation was 44.08 + 24.67 years and 46.51 + 19.24 years respectively, (p=0.96). Mean surgical interventions were 2.86 + 1.45 in the BN group and 6.36 + 2.89 in the BP group respectively, (p<0.0001, 95% C.I. 2 to 4). Median follow up was 6 months and 5 months respectively (p=0.33). Final logMAR vision noted was a median of 1.2 and 1.9 respectively (p=0.0005, 95% C.I. 0.4 to 1.7). Functional success noted was 44% and 21.2% (p=0.03, 95% C.I. 1.86% to 40.08%). Anatomic success was noted in 68% and 42.42% respectively (p=0.02, 95% C.I. 3.85% to 45.47%). The antimicrobial resistance patterns between the two groups were comparable.
Conclusion: Bacteria with in-vivo biofilm formation in endophthalmitis, show enhanced in-vivo virulence leading to increased need of surgical intervention and a reduction in the final anatomic and functional success.
Support: Hyderabad Eye Research Foundation
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