title: Endophthalmitis caused by Achromobacter xylosoxidans after cataract surgery.
abstract: OBJECTIVE
  To report Achromobacter xylosoxidans as a cause of both acute-onset and delayed-onset postoperative endophthalmitis after cataract surgery.
  
  
  METHODS
  A noncomparative consecutive case series of patients with culture-proven A. xylosoxidans endophthalmitis between 1970 and 2012. Cataract surgery and intraocular lens placement were performed in all patients before endophthalmitis. Positive cultures were obtained from the vitreous, capsular bag, and/or the removed intraocular lens.
  
  
  RESULTS
  The clinical diagnosis was confirmed in four patients with positive cultures. Two patients with endophthalmitis had a preliminary culture report of Pseudomonas species. In addition to receiving intravitreal antibiotics, all patients underwent capsulectomy and intraocular lens removal at the time of pars plana vitrectomy. Visual acuity at last follow-up was 20/40 or better in 2 (50%) of the 4 patients, but the remaining 2 patients were 20/200 or worse.
  
  
  CONCLUSIONS
  A. xylosoxidans may be a cause of acute, recurrent, and delayed-onset postoperative endophthalmitis after cataract surgery. Complete capsulectomy and intraocular lens removal can be considered in recurrent and recalcitrant patients.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Victor M
authors.initials: VM
authors.lastname: Villegas
authors.forename: Andres
authors.initials: A
authors.lastname: Emanuelli
authors.forename: Harry W
authors.initials: HW
authors.lastname: Flynn
authors.forename: Audina M
authors.initials: AM
authors.lastname: Berrocal
authors.forename: Darlene
authors.initials: D
authors.lastname: Miller
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Kao
authors.forename: Sander R
authors.initials: SR
authors.lastname: Dubovy
authors.forename: Eduardo
authors.initials: E
authors.lastname: Alfonso
mesh_terms: D042441:Achromobacter denitrificans / Q000302:isolation & purification*; D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects*; D009877:Endophthalmitis / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged