Alcaligenes xylosoxidans endophthalmitis following phacoemulsification and intraocular lens implantation.
Five consecutive cases of endophthalmitis that developed after cataract extraction by a single surgeon using the same operating room during one morning session are described. Following preoperative topical administration of ciprofloxacin, surgery consisted of phacoemulsification with peristaltic pump and fluid venting, polymethylmethacrylate intraocular lens implantation, and corneal suture. No complications occurred during surgery. All five patients developed endophthalmitis caused by infection with Alcaligenes xylosoxidans in less than 24 hours. Pulsed-field gel electrophoresis was used to prove similarity between strains. Bacterial inquiry on contamination of the operating room environment revealed massive colonization of phacoemulsifier irrigation channels by Pseudomonas fluorescens bacteria from an unestablished source. Four of the five patients ultimately recovered visual acuity better than 20/60.
Robert
Pierre-Yves
PY
Department of Ophthalmology, CHU Dupuytren, 2 av Martin Luther King, 87042 Limoges Cedex, France.
Chainier
Delphine
D
Garnier
Fabien
F
Ploy
Marie-Cécile
MC
Parneix
Pierre
P
Adenis
Jean-Paul
JP
Martin
Christian
C
D042441:Achromobacter denitrificans / Q000302:isolation & purification*; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002437:Cefazolin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D016521:Electrophoresis, Gel, Pulsed-Field; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004866:Equipment Contamination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification / Q000295:instrumentation*; D011183:Postoperative Complications; D014640:Vancomycin / Q000627:therapeutic use; D014792:Visual Acuity
D000900:Anti-Bacterial Agents; D014640:Vancomycin; D002437:Cefazolin