title: Clinical features, microbiological profile and treatment outcome of patients with Corynebacterium endophthalmitis: review of a decade from a tertiary eye care centre in southern India.
abstract: OBJECTIVE
  To report the clinical and microbiological profile along with treatment outcome of patients with endophthalmitis caused by Corynebacterium sp.
  
  
  METHODS
  This is a retrospective, consecutive, non-comparative case series of patients with culture-proven Corynebacterium endophthalmitis seen between August 2004 and July 2014.
  
  
  RESULTS
  Of 5439 patients clinically diagnosed as infective endophthalmitis, vitreous samples were culture positive for bacteria in 1488 (27%). Sixteen patients (1%) were identified as Corynebacterium endophthalmitis. The clinical settings included trauma (n=10), post-cataract surgery (n=5) and post-penetrating keratoplasty (n=1). In 7/16 (44%) patients, the organisms were visualised in direct microscopy. Tested by disc-diffusion method, all isolates were vancomycin sensitive. However, 9 of 10 isolates were resistant to ceftazidime and 5 of 14 isolates were resistant to amikacin. Initial treatment strategies included pars plana vitrectomy with intravitreal antibiotics (vancomycin and amikacin/ceftazidime) injection (n=9) and pars plana lensectomy along with pars plana vitrectomy and intravitreal antibiotics (vancomycin and amikacin/ceftazidime) injection (n=7). Final visual acuity was 20/200 or better in 11 (69%) of 16 patients.
  
  
  CONCLUSIONS
  The prevalence of corynebacterial endophthalmitis is low. The organisms are susceptible to vancomycin, and early appropriate treatment results in favourable outcome.
authors.affiliation: Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Hyderabad, Telangana, India.
authors.forename: Joveeta
authors.initials: J
authors.lastname: Joseph
authors.affiliation: Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Hyderabad, Telangana, India.
authors.forename: Khemlal
authors.initials: K
authors.lastname: Nirmalkar
authors.affiliation: Smt. Kanuri Santamma centre for vitreo-retinal diseases, L. V. Prasad Eye Institute, Hyderabad, Telangana, India.
authors.forename: Annie
authors.initials: A
authors.lastname: Mathai
authors.affiliation: Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Hyderabad, Telangana, India.
authors.forename: Savitri
authors.initials: S
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003352:Corynebacterium / Q000187:drug effects / Q000302:isolation & purification*; D003354:Corynebacterium Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014640:Vancomycin / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: Infection; Microbiology; Retina; Treatment Medical; Vitreous