title: Prognostic factors and outcomes in endogenous Klebsiella pneumoniae endophthalmitis.
abstract: OBJECTIVE
  To determine risk factors for poor visual acuity outcomes in patients with endogenous Klebsiella pneumoniae endophthalmitis.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  We reviewed all consecutive patients diagnosed with endogenous Klebsiella pneumoniae endophthalmitis over 20 years. Data collected included patients' demographics, clinical findings, investigations, and therapeutic intervention. Main outcome measures were visual acuity (VA) at 3 months postinfection and/or evisceration. Poor vision was defined as VA worse than 4/200.
  
  
  RESULTS
  Seventy-one eyes of 61 patients were studied. Mean age was 55.7 (standard deviation [SD] ± 13.1) years. Majority were male (49/61, 80.3%), Chinese (51/61, 83.6%), and had hepatobiliary sepsis (47/61, 77.5%). Mean time to ocular symptoms was 4.4 (± 3.0) days. Fifty-four of 71 eyes (80.2%) had poor vision and 19/71 eyes (26.8%) required evisceration. The most significant risk factor was hypopyon (41/71 eyes, 57.7%) on multivariate analysis (odds ratio [OR], 52.6; 95% confidence interval [CI], 1.7-1000; P = .01). Unilateral involvement (OR, 10.4; 95% CI, 1.2-90.2; P = .01) and patients that were managed before year 2000 (before routine screening was implemented) (OR, 5.2; 95% CI, 1.5-17.9; P = .037) were significant risk factors for evisceration on multivariate analysis.
  
  
  CONCLUSIONS
  Patients presenting with hypopyon and unilateral involvement have a poorer prognosis.
authors.affiliation: Singapore National Eye Centre, Singapore.
authors.forename: Marcus
authors.initials: M
authors.lastname: Ang
authors.forename: Aliza
authors.initials: A
authors.lastname: Jap
authors.forename: Soon-Phaik
authors.initials: SP
authors.lastname: Chee
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002442:Ceftazidime / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D017234:Eye Evisceration; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014640:Vancomycin / Q000627:therapeutic use; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D002442:Ceftazidime