title: The diabetic ocular environment facilitates the development of endogenous bacterial endophthalmitis.
abstract: OBJECTIVE
  We tested the hypothesis that changes in the diabetic ocular environment facilitate the development of endogenous bacterial endophthalmitis (EBE).
  
  
  METHODS
  C57BL/6J mice were rendered diabetic with streptozotocin (STZ) for 1, 3, or 5 months' duration. Diabetic and age-matched nondiabetic mice were tail vein-injected with 10(8) CFU of Klebsiella pneumoniae, a common cause of EBE in diabetics. After either 2 or 4 days postinfection, the EBE incidence was assessed by electroretinography, histology, bacterial counts, and myeloperoxidase ELISAs. Blood-retinal barrier (BRB) permeability in uninfected diabetic mice also was determined.
  
  
  RESULTS
  No cases of EBE were observed among the 1-month diabetic group. Extending the time from diabetes induction to 3 months resulted in a 23.8% EBE incidence after 2 days, and a 22% incidence after 4 days. The incidence of EBE increased to 27% in the 5-month diabetic group. Infected eyes had an average 8.01 × 10(2) and 6.19 × 10(4) CFU/eye for the 3- and 5-month diabetic groups, respectively. There was no significant difference in BRB permeability between control and 1-month uninfected diabetic mice. However, 3- and 5-month diabetic mice had significantly greater BRB permeability than control mice. These results suggested that increasing the time from STZ diabetes induction to 3 and 5 months resulted in an ocular environment more conducive to the development of EBE.
  
  
  CONCLUSIONS
  These results demonstrated a correlation between an increase in BRB permeability and an increase in EBE incidence, supporting the hypothesis that diabetic ocular changes contribute to the development of EBE.
authors.affiliation: Department of Ophthalmology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: Phillip S
authors.initials: PS
authors.lastname: Coburn
authors.forename: Brandt J
authors.initials: BJ
authors.lastname: Wiskur
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Christy
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Callegan
mesh_terms: D000818:Animals; D002199:Capillary Permeability; D003921:Diabetes Mellitus, Experimental; D003930:Diabetic Retinopathy / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D004195:Disease Models, Animal; D004596:Electroretinography; D009877:Endophthalmitis / Q000209:etiology / Q000382:microbiology* / Q000473:pathology; D015818:Eye Infections, Bacterial / Q000209:etiology / Q000382:microbiology* / Q000473:pathology; D005500:Follow-Up Studies; D007710:Klebsiella Infections / Q000209:etiology / Q000382:microbiology* / Q000473:pathology; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D051379:Mice; D008810:Mice, Inbred C57BL; D012171:Retinal Vessels / Q000378:metabolism / Q000473:pathology*