Postoperative Mycobacteroides abscessus subsp. abscessus endophthalmitis: Clinical analysis of 12 clustered adults and a proposed therapeutic algorithm
Purpose: Postoperative endophthalmitis caused by nontuberculous mycobacterium is a rare but devastating complication after intraocular surgery. However, optimal treatment strategies remain undetermined in view of its rarity. Methods: We investigated the cases of culture-proven postoperative Mycobact...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-10-01
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| Series: | Journal of Microbiology, Immunology and Infection |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118218303499 |
| _version_ | 1818118102043328512 |
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| author | Jia-Horung Hung Wen-Chien Ko Chau-Yin Chen Sheng-Hsiang Lin Cheng-Lin Wu Sheng-Min Hsu Yu-Ti Teng Shih-Hao Wang Sung-Huei Tseng Fu-Chin Huang Chun-Chieh Lai Ching-Lung Chen Chien-Hsiung Lai Po-Lin Chen Evelyn Jou-Chen Huang |
| author_facet | Jia-Horung Hung Wen-Chien Ko Chau-Yin Chen Sheng-Hsiang Lin Cheng-Lin Wu Sheng-Min Hsu Yu-Ti Teng Shih-Hao Wang Sung-Huei Tseng Fu-Chin Huang Chun-Chieh Lai Ching-Lung Chen Chien-Hsiung Lai Po-Lin Chen Evelyn Jou-Chen Huang |
| author_sort | Jia-Horung Hung |
| collection | DOAJ |
| description | Purpose: Postoperative endophthalmitis caused by nontuberculous mycobacterium is a rare but devastating complication after intraocular surgery. However, optimal treatment strategies remain undetermined in view of its rarity. Methods: We investigated the cases of culture-proven postoperative Mycobacteroides abscessus subsp. abscessus endophthalmitis in southern Taiwan, focusing on clinical manifestations and microbiological study, and aimed to describe clinical staging and to propose a therapeutic modality for this disease. Results: Twelve cases, including two published cases, were treated in two medical centers in southern Taiwan between Aug. 2011 and Dec. 2016, and all ever received cataract surgery at one clinic. Their disease courses could be categorized into four distinct stages, i.e., the initial, quiescent, recurrent, and end stage, and some cases experienced 1–4 cycles of quiescent-recurrent stages. Although all eyes ended up with phthisis or were eviscerated, the affected eyes receiving pars plana vitrectomy (PPV) tended to become quiescent and survived longer than those without PPV (adjusted hazard ratio: 13.9, p < 0.05). Eight isolates of eight patients were available for microbiological study. All isolates were susceptible to amikacin, and inducible clarithromycin resistance was observed in 100% of isolates. Conclusion: Despite the preservation of vision in postoperative M. abscessus endophthalmitis remained a challenge, a stage-based approach is proposed, which may facilitate decision-makings for the future study. |
| first_indexed | 2024-12-11T04:48:58Z |
| format | Article |
| id | doaj.art-646c43956b1744ceb71413ba441f5153 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-12-11T04:48:58Z |
| publishDate | 2020-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-646c43956b1744ceb71413ba441f51532022-12-22T01:20:27ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822020-10-01535766777Postoperative Mycobacteroides abscessus subsp. abscessus endophthalmitis: Clinical analysis of 12 clustered adults and a proposed therapeutic algorithmJia-Horung Hung0Wen-Chien Ko1Chau-Yin Chen2Sheng-Hsiang Lin3Cheng-Lin Wu4Sheng-Min Hsu5Yu-Ti Teng6Shih-Hao Wang7Sung-Huei Tseng8Fu-Chin Huang9Chun-Chieh Lai10Ching-Lung Chen11Chien-Hsiung Lai12Po-Lin Chen13Evelyn Jou-Chen Huang14Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Diagnostic Microbiology and Antimicrobial Resistance Laboratory, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, TaiwanInstitute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanInstitute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanInstitute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Diagnostic Microbiology and Antimicrobial Resistance Laboratory, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Taiwan; Corresponding author. Department of Microbiology and Immunology. College of Medicine, National Cheng Kung University, 138, Sheng-Li Rd., Tainan, Taiwan. Fax: +886 6 2766177.Department of Ophthalmology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Ophthalmology, School of Medicine, College of Medicine, Taipei Medical University, Taiwan; Corresponding author. Department of Ophthalmology, Taipei Medical University Hospital, No.250, Wuxing St., Xinyi Dist., Taipei, 110, Taiwan.Purpose: Postoperative endophthalmitis caused by nontuberculous mycobacterium is a rare but devastating complication after intraocular surgery. However, optimal treatment strategies remain undetermined in view of its rarity. Methods: We investigated the cases of culture-proven postoperative Mycobacteroides abscessus subsp. abscessus endophthalmitis in southern Taiwan, focusing on clinical manifestations and microbiological study, and aimed to describe clinical staging and to propose a therapeutic modality for this disease. Results: Twelve cases, including two published cases, were treated in two medical centers in southern Taiwan between Aug. 2011 and Dec. 2016, and all ever received cataract surgery at one clinic. Their disease courses could be categorized into four distinct stages, i.e., the initial, quiescent, recurrent, and end stage, and some cases experienced 1–4 cycles of quiescent-recurrent stages. Although all eyes ended up with phthisis or were eviscerated, the affected eyes receiving pars plana vitrectomy (PPV) tended to become quiescent and survived longer than those without PPV (adjusted hazard ratio: 13.9, p < 0.05). Eight isolates of eight patients were available for microbiological study. All isolates were susceptible to amikacin, and inducible clarithromycin resistance was observed in 100% of isolates. Conclusion: Despite the preservation of vision in postoperative M. abscessus endophthalmitis remained a challenge, a stage-based approach is proposed, which may facilitate decision-makings for the future study.http://www.sciencedirect.com/science/article/pii/S1684118218303499EndophthalmitisMycobacteroides abscessus subsp. abscessus |
| spellingShingle | Jia-Horung Hung Wen-Chien Ko Chau-Yin Chen Sheng-Hsiang Lin Cheng-Lin Wu Sheng-Min Hsu Yu-Ti Teng Shih-Hao Wang Sung-Huei Tseng Fu-Chin Huang Chun-Chieh Lai Ching-Lung Chen Chien-Hsiung Lai Po-Lin Chen Evelyn Jou-Chen Huang Postoperative Mycobacteroides abscessus subsp. abscessus endophthalmitis: Clinical analysis of 12 clustered adults and a proposed therapeutic algorithm Journal of Microbiology, Immunology and Infection Endophthalmitis Mycobacteroides abscessus subsp. abscessus |
| title | Postoperative Mycobacteroides abscessus subsp. abscessus endophthalmitis: Clinical analysis of 12 clustered adults and a proposed therapeutic algorithm |
| title_full | Postoperative Mycobacteroides abscessus subsp. abscessus endophthalmitis: Clinical analysis of 12 clustered adults and a proposed therapeutic algorithm |
| title_fullStr | Postoperative Mycobacteroides abscessus subsp. abscessus endophthalmitis: Clinical analysis of 12 clustered adults and a proposed therapeutic algorithm |
| title_full_unstemmed | Postoperative Mycobacteroides abscessus subsp. abscessus endophthalmitis: Clinical analysis of 12 clustered adults and a proposed therapeutic algorithm |
| title_short | Postoperative Mycobacteroides abscessus subsp. abscessus endophthalmitis: Clinical analysis of 12 clustered adults and a proposed therapeutic algorithm |
| title_sort | postoperative mycobacteroides abscessus subsp abscessus endophthalmitis clinical analysis of 12 clustered adults and a proposed therapeutic algorithm |
| topic | Endophthalmitis Mycobacteroides abscessus subsp. abscessus |
| url | http://www.sciencedirect.com/science/article/pii/S1684118218303499 |
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