title: Outcome of the patients with post-operative cluster endophthalmitis referred to a tertiary level eye care center in Nepal.
abstract: BACKGROUND
  The causative organism and treatment outcomes of post operative endophthalmitis may vary depending on several factors.
  
  
  OBJECTIVE
  To find out the causative organisms and visual outcome after an outbreak of post-operative endophthalmitis.
  
  
  METHODS
  An interventional prospective series of cases of clinically suspected endophthalmitis was studied. Eleven patients who presented within 48 hours after manual cataract surgery on the same day, by a one surgeon in a single center were enrolled in the study. They underwent both anterior chamber and vitreous aspiration and all of them received intravitreal Vancomycin, Amikacin and Dexamethasone. Samples were subjected to microbiological evaluation. All patients were followed up till 8 weeks for clinical and visual outcome.
  
  
  RESULTS
  Of the 11 eyes of suspected endopthalmitis, only one vitreous aspiration showed Gram negative bacilli on Gram stain and 3 vitreous aspirates showed Gram positive cocci. Of the 11 eyes, 3(42.85%) had culture positive on vitreous aspirate. In 2 cases E Coli was isolated and in 1 Staphylococcus aureus was isolated. After 48 hours of intravitreal injection, 10 out of 11 eyes improved and in one, intravitreal injection of vancomycin, amikacin and dexamethasone was repeated. The best corrected visual acuity of 6/9 was achieved in 2 patients, 5 had 6/18, 2 had 6/60 and 2 had 5/60 at the end of eight weeks.
  
  
  CONCLUSIONS
  Staphylococcus aureus and E coli can cause endophthalmitis immediately on the first day post-operatively. Clinically suspected endophthalmitis treated with antibiotics and steroid intravitreal injection can result in better visual outcome.
authors.forename: P
authors.initials: P
authors.lastname: Gautam
authors.forename: S N
authors.initials: SN
authors.lastname: Joshi
authors.forename: A
authors.initials: A
authors.lastname: Sharma
authors.forename: M
authors.initials: M
authors.lastname: Thapa
authors.forename: D N
authors.initials: DN
authors.lastname: Shah
authors.forename: A K
authors.initials: AK
authors.lastname: Sharma
authors.forename: D N
authors.initials: DN
authors.lastname: Shah
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002387:Cataract Extraction / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use; D009877:Endophthalmitis / Q000188:drug therapy* / Q000382:microbiology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009390:Nepal; D011446:Prospective Studies; D012017:Referral and Consultation; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000382:microbiology*; D062606:Tertiary Care Centers; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D003907:Dexamethasone