Katherine Talcott, MD: 5-Year Review of Endogenous Bacterial Endophthalmitis

A new study from investigators at Wills Eye Hospital is offering physicians more information on the incidence and characteristics of endogenous bacterial endophthalmitis.

To further assess a cohort of patients with endogenous bacterial endophthalmitis, investigators conducted a retrospective review of 41 patients over a 5-year period. From those 41 patients, 49 eyes were included.

Of the 49 eyes, investigators observed 42 with causative organisms and gram-positive bacteria accounted for 36 of those infections. Gram negative bacteria accounted for an additional 4 and bacilli accounted for the remaining 2. Endocarditis was the most common source of endophthalmitis.

There were no differences in changes of visual acuity based on gram stain, duration of symptoms prior to treatment, or number of intravitreal antibacterial injections.

Between sessions at the American Academy of Ophthalmology (AAO) 2019 Annual Meeting in San Francisco, MD Magazine® sat down with study investigator Katherine Talcott, MD, staff physician at the Cole Eye Institute, for her clinical takeaways from the study.

MD Mag: Can you describe the results of your 5-year study examining endogenous bacterial endophthalmitis?

Talcott: So, that is a study that we looked at—at Wills Eye Hospital—with all the patients who presented with endogenous endophthalmitis to try and be able to better tease out what bugs were affecting things and how people did. We found that most of those patients did not end up needing surgery that they ended up needing just intravitreal antibiotics but it's challenging.

I think one of the things that we found is it's challenging to sort of get long-term follow-up for those patients because they're often taken care of in a hospital setting and we don't have as much information but I think what we're seeing is there's an emergence of people who have bilateral disease as opposed to unilateral disease. I think that reflects that these patients have endogenous endophthalmitis versus something from like cataract surgery or like an injection. So, it's kind of a different entity than I think most of these endophthalmitis patients we think about.