Nosocomial acute-onset postoperative endophthalmitis at a university teaching hospital (2002-2009).
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.
Wykoff
Charles C
CC
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, 900 NW 17th Street, Miami, Florida. cwykoff@med.miami.edu
Parrott
M Brandon
MB
Flynn
Harry W
HW
Shi
Wei
W
Miller
Darlene
D
Alfonso
Eduardo C
EC
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