title: Alcaligenes xylosoxidans endophthalmitis following phacoemulsification and intraocular lens implantation.
abstract: 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.
authors.affiliation: Department of Ophthalmology, CHU Dupuytren, 2 av Martin Luther King, 87042 Limoges Cedex, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Robert
authors.forename: Delphine
authors.initials: D
authors.lastname: Chainier
authors.forename: Fabien
authors.initials: F
authors.lastname: Garnier
authors.forename: Marie-Cécile
authors.initials: MC
authors.lastname: Ploy
authors.forename: Pierre
authors.initials: P
authors.lastname: Parneix
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Adenis
authors.forename: Christian
authors.initials: C
authors.lastname: Martin
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D002437:Cefazolin