title: Nosocomial acute-onset postoperative endophthalmitis at a university teaching hospital (2002-2009).
abstract: OBJECTIVE
  To evaluate acute-onset postoperative endophthalmitis occurring at an academic medical center and to compare rates over the last 25 years at a single institution.
  
  
  METHODS
  Retrospective, consecutive case series.
  
  
  METHODS
  Medical records were reviewed for all patients diagnosed with acute-onset postoperative nosocomial endophthalmitis from 2002 through 2009 associated with surgery at Bascom Palmer Eye Institute.
  
  
  RESULTS
  The 8-year frequency of acute-onset postoperative endophthalmitis was 0.025% (14 of 56 672 intraocular surgeries). The rate was 0.028% (8/28 568) for cataract surgery and 0.011% (2/18 492) for pars plana vitrectomy (PPV). Both PPV endophthalmitis cases followed 20-gauge surgery and no cases followed small-gauge, transconjunctival PPV (n = 2262). Three cases occurred following penetrating keratoplasty (3/2788, 0.108%). The most common bacterial isolate was Staphylococcus (n = 7, 50%). Initial treatment involved ocular paracentesis (n = 8, 57%) or vitrectomy (n = 5, 36%), in combination with injection of intraocular antibiotics (n = 14, 100%). Vancomycin and ceftazidime were used in 13 eyes (93%) and intraocular steroids were given initially to 9 eyes (64%). Final visual acuity was > or =20/200 in 9 eyes (64%) and 2 eyes (14%) were no light perception. At this institution since 1984, there has been a statistically significant trend for a decreasing rate of acute-onset postoperative endophthalmitis (1984-1994: 0.09%; 1995-2001: 0.05%; 2002-2009: 0.025%; P < .001).
  
  
  CONCLUSIONS
  At a university teaching hospital involving resident, fellow, and faculty surgeons, the frequency of acute-onset postoperative nosocomial endophthalmitis is low, has not increased in the era of sutureless clear corneal cataract surgery, and has steadily decreased when compared to prior time periods from the same institution.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, 900 NW 17th Street, Miami, Florida. cwykoff@med.miami.edu
authors.forename: Charles C
authors.initials: CC
authors.lastname: Wykoff
authors.forename: M Brandon
authors.initials: MB
authors.lastname: Parrott
authors.forename: Harry W
authors.initials: HW
authors.lastname: Flynn
authors.forename: Wei
authors.initials: W
authors.lastname: Shi
authors.forename: Darlene
authors.initials: D
authors.lastname: Miller
authors.forename: Eduardo C
authors.initials: EC
authors.lastname: Alfonso
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D009877:Endophthalmitis / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D015818:Eye Infections, Bacterial / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D005260:Female; D005431:Florida / Q000453:epidemiology; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D055815:Young Adult