title: Comparison of clinico-microbiological profile and treatment outcome of in-house and referred post cataract surgery endophthalmitis in a tertiary care center in South India.
abstract: BACKGROUND
  The purpose of the study is to compare the clinico-microbiological profile and treatment outcome of in-house vs referred cases of post cataract surgery endophthalmitis in a tertiary eye care facility in South India.
  
  
  METHODS
  The clinical records of 50 culture-positive cases each of in-house (group A) and referred (group B) post cataract surgery endophthalmitis were analyzed. The management protocol was similar in both groups.
  
  
  RESULTS
  The time to report to the institute was longer in group B (group B 13.63 [±11.67; 95% CI, 9.95-17.31] days; group A 6.83 [±7.61; 95% CI, 4.57-9.09] days; P = 0.002). The average inflammatory scores in presentation were comparable (group A 17.85 ± 5.83; group B 18.18 ± 7.35; P = 0.243). The final visual outcome was clinically superior in group A (≥20/200-group A 60.42% and group B 44%, P = 0.11; ≤20/400-group A 37.5% and group B 52%, P = 0.62), but statistically not significant. There were more gram-positive organisms in group A (62% vs 38%; P = 0.027) and more gram-negative organisms in group B (52% vs 24%; P = 0.007). Gram-positive bacteria were mostly sensitive to vancomycin (95.24% to 96.67%), but gram-negative bacteria were partly sensitive to ceftazidime (58.33% to 64%).
  
  
  CONCLUSIONS
  One could suspect gram-negative infection more often in the referred cases of endophthalmitis. While vancomycin could continue to be the antibiotic of choice in gram-positive bacteria, specific antibiotic following due sensitivity for gram-negative bacteria should replace the empiric use of ceftazidime.
authors.affiliation: Srimati Kanuri Santhamma Retina Vitreous Center, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Ambiya
authors.affiliation: Srimati Kanuri Santhamma Retina Vitreous Center, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India. tpd@lvpei.org.|LV Prasad Eye Institute, Road No. 2, LV Prasad Marg, Banjara Hills, Hyderabad, 500034, India. tpd@lvpei.org.
authors.forename: Taraprasad
authors.identifier: http://orcid.org/0000-0002-1295-4528
authors.initials: T
authors.lastname: Das
authors.affiliation: Jhaveri Microbiology Center, Brien Holden Research Center, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: Savitri
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Srimati Kanuri Santhamma Retina Vitreous Center, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: Jay
authors.initials: J
authors.lastname: Chhablani
authors.affiliation: Srimati Kanuri Santhamma Retina Vitreous Center, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Dave
authors.affiliation: Srimati Kanuri Santhamma Retina Vitreous Center, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: Subhadra
authors.initials: S
authors.lastname: Jalali
authors.affiliation: Srimati Kanuri Santhamma Retina Vitreous Center, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: Raja
authors.initials: R
authors.lastname: Narayanan
authors.affiliation: Jhaveri Microbiology Center, Brien Holden Research Center, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: Joveeta
authors.initials: J
authors.lastname: Joseph