Infectious Sources, Prognostic Factors, and Visual Outcomes of Endogenous  Klebsiella pneumoniae  Endophthalmitis

Purpose. To evaluate visual outcomes and identify prognostic factors after pars plana vitrectomy (PPV) surgery for traumatic endophthalmitis. Methods. Medical records of 121 consecutive patients (121 eyes) diagnosed with traumatic endophthalmitis that had undergone pars plana vitrectomy were retrospectively reviewed. Results. 121 patients, aged from 6 to 71 years, all underwent PPV surgery. 113 cases had improved best corrected visual acuity (BCVA) after surgery and 60% of them obtained BCVA better than fingers counting (FC). Good final visual prognosis was significantly associated with time between trauma and initial treatment less than 12 hrs (40% versus 98%; P<0.001), time between trauma and PPV treatment less than 24 hrs (62% versus 98%; P<0.001), laceration length less than 10 mm (63% versus 96%; P<0.001), and presenting VA better than LP (42% versus 96%; P<0.001), while gender, type of laceration, presence of IOFB or retinal detachment, and the use of silicone oil tamponade were not significant factors resulting in better BCVA. Bacteria were identified in 43.8% of specimens and most of the microorganisms were identified as nonvirulent ones. Conclusions. Pars plana vitrectomy surgery was preferred as a primary treatment option for traumatic endophthalmitis. A good final visual prognosis was significantly associated with timely treatment, prompt vitrectomy surgery, shorter length of laceration, and better presenting visual acuity.

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Comment on “Visual Outcomes and Prognostic Factors of Successful Penetrating Keratoplasty in 0- to 7-Year-Old Children With Congenital Corneal Opacities”

Cornea ◽

10.1097/00003226-900000000-96650 ◽

2018 ◽

pp. 1

Author(s):

Prafulla K. Maharana ◽

Pranita Sahay ◽

Ritu Nagpal

Keyword(s):

Prognostic Factors ◽

Penetrating Keratoplasty ◽

Visual Outcomes ◽

Corneal Opacities

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Clinical and Microbiological Prognostic Factors of In-Hospital Mortality Caused by Hypervirulent Klebsiella Pneumoniae Infections: A Retrospective Study in a Tertiary Hospital of Southwestern China

10.21203/rs.3.rs-27245/v1 ◽

2020 ◽

Author(s):

Yu Tang ◽

Hang Liu ◽

Jinxin Zhao ◽

Jiaqi Zou ◽

Yingzhu Chen ◽

...

Keyword(s):

Prognostic Factors ◽

Retrospective Study ◽

Klebsiella Pneumoniae ◽

Hospital Mortality ◽

Univariate Analysis ◽

Multivariate Logistic Regression Analysis ◽

Tertiary Hospital ◽

Southwestern China ◽

Inverse Association ◽

Survivor Group

Abstract Background Hypervirulent klebsiella pneumoniae (hvKP) is responsible for various invasive diseases and is associated with high mortality. However, the clinical and microbiological factors of hvKP infection to affect prognosis are not well studied. The purpose of this study is to evaluate prognostic factors of in-hospital mortality of hvKP infection, mainly focusing on clinical and microbiological characteristics. Methods A retrospective study was conducted in southwestern China from February 2018 to June 2019 and strains positive for aerobactin and string test were defined as hvKP. According to the clinical outcomes during hospitalization, hvKP infected patients were divided into non-survivor group and survivor group. The clinical characteristics, capsule serotypes, multi-locus sequence types, virulence genes and antimicrobial susceptibility were compared between the two groups. Results A total of 135 patients were classified as hvKP infection, with a prevalence rate of 22% and an in-hospital mortality rate of 11.9%. Univariate analysis exhibited that admission to intensive care unit (ICU)(p=0.008) and antimicrobial resistance of hvKP such as ampicillin/sulbactam(p=0.028), cefepime(p=0.033), aztreonam(p=0.049) and harboring iroN gene(p=0.023) were associated with higher in-hospital mortality. On the contrary, the rmpA gene showed an inverse association with in-hospital mortality(p=0.017). Multivariate logistic regression analysis revealed that admission to ICU (odds ratio [OR]=3.452, 95% confidence interval [CI]=1.052-11.329; P=0.041) and presence of iroN (OR=9.278, 95% CI=1.654-52.035; P=0.011) was considered to be the independent prognostic factors for in-hospital mortality of hvKP infection. Conclusion Emerging hvKP infection may lead to relatively high in-hospital mortality. Therefore, early surveillance and better management are necessary for patients admitted to ICU and infected with hvKP harboring iroN gene.

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Prognostic Factors and Epidemiology of Open Globe Injuries from Western Sydney: A Twelve-Year Review

10.21203/rs.3.rs-294147/v1 ◽

2021 ◽

Author(s):

Haochi Ho ◽

Jane Foo ◽

Yi-Chiao Li ◽

Samantha Bobba ◽

Christopher Go ◽

...

Keyword(s):

Visual Acuity ◽

Prognostic Factors ◽

Retinal Detachment ◽

Case Series ◽

Final Visual Acuity ◽

Ocular Injury ◽

Visual Outcomes ◽

Globe Rupture ◽

Open Globe ◽

Open Globe Injuries

Abstract BackgroundTo identify prognostic factors determining final visual outcome following open globe injuries.MethodsRetrospective case series of patients presenting to Westmead Hospital, Sydney, Australia with open globe injuries from 1st January 2005 to 31st December 2017. Data collected included demographic information, ocular injury details, management and initial and final visual acuities.ResultsA total of 104 cases were identified. Predictors of poor final visual outcomes included poor presenting visual acuity (p < 0.001), globe rupture (p < 0.001), retinal detachment (p < 0.001), Zone III wounds (p < 0.001), hyphema (p=0.003), lens expulsion (p = 0.003) and vitreous hemorrhage (p < 0.001). Multivariate analysis demonstrated presenting visual acuity (p < 0.001), globe rupture (p = 0.013) and retinal detachment (p = 0.011) as being statistically significant for predicting poor visual outcomes. The presence of lid laceration (p = 0.197) and uveal prolapse (p = 0.667) were not significantly associated with the final visual acuity. ConclusionsPoor presenting visual acuity, globe rupture and retinal detachment are the most important prognostic factors determining final visual acuity following open globe injury.

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