title: Relationship between baseline clinical data and microbiologic spectrum in 100 patients with acute postcataract endophthalmitis.
abstract: OBJECTIVE
  To correlate the initial ocular presentation with bacterial identification in 100 patients with acute postcataract endophthalmitis.
  
  
  METHODS
  This was a prospective multicenter study. Demographic data, medical history, and the initial eye examination data were recorded on a standardized form. The relationship between bacterial identification and clinical factors at baseline was studied using univariate and multivariate analyses.
  
  
  RESULTS
  One hundred patients were admitted to the hospital with a median delay of 6 days after cataract surgery. The main symptoms were loss of vision (94.9%) and pain (75.5%). Major clinical signs were hypopyon (72%), pupillary fibrin membrane (77.5%), and loss of fundus visibility (90%). Baseline factors significantly associated with microbiologic identification were as follows: diabetes mellitus, a shorter delay of onset, initial visual acuity limited to light perception, higher intraocular pressure, chemosis, pupillary fibrin membrane, loss of the red reflex, and reduced fundus visibility. As compared with other bacteria, the identification of Streptococcus species (n = 19) was more frequently associated with male gender, diabetes mellitus, initial visual acuity limited to light perception, and pain. The Staphylococcus aureus and Staphylococcus lugdunensis group (n = 14) differed from other coagulase-negative Staphylococcus groups (n = 33) in that those patients had greater hypopyon height.
  
  
  CONCLUSIONS
  The baseline features of acute endophthalmitis after cataract surgery in the era of phacoemulsification are similar to those reported in the Endophthalmitis Vitrectomy Study 15 years ago and differ according to the bacterial species. The association between the clinical signs and the microbiologic identification suggests that initial characteristics other than visual acuity may be useful in identifying patients presumed to be infected with a virulent species.
authors.affiliation: Department of Ophthalmology, Hospices Civils de Lyon, University Hospital, Claude Bernard Lyon I University, Lyon, France. pierre-loic.cornut@chu-lyon.fr
authors.forename: Pierre-Loïc
authors.initials: PL
authors.lastname: Cornut
authors.forename: Gilles
authors.initials: G
authors.lastname: Thuret
authors.forename: Catherine
authors.initials: C
authors.lastname: Creuzot-Garcher
authors.forename: Max
authors.initials: M
authors.lastname: Maurin
authors.forename: Andre
authors.initials: A
authors.lastname: Pechinot
authors.forename: Alain
authors.initials: A
authors.lastname: Bron
authors.forename: Philippe
authors.initials: P
authors.lastname: Gain
authors.forename: Anne
authors.initials: A
authors.lastname: Carricajo
authors.forename: Philippe
authors.initials: P
authors.lastname: Denis
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Romanet
authors.forename: Francois
authors.initials: F
authors.lastname: Vandenesch
authors.forename: Christophe
authors.initials: C
authors.lastname: Chiquet
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001419:Bacteria / Q000302:isolation & purification*; D002387:Cataract Extraction / Q000009:adverse effects*; D009877:Endophthalmitis / Q000382:microbiology* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013210:Staphylococcus / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification; D014792:Visual Acuity / Q000502:physiology; D014796:Visual Perception / Q000502:physiology