TY - JOUR
T1 - Postoperative Mycobacteroides abscessus subsp. abscessus endophthalmitis
T2 - Clinical analysis of 12 clustered adults and a proposed therapeutic algorithm
AU - Hung, Jia-Horung
AU - Ko, Wen-Chien
AU - Chen, Chau Yin
AU - Lin, Sheng-Hsiang
AU - Wu, Cheng Lin
AU - Hsu, Sheng-Min
AU - Teng, Yu Ti
AU - Wang, Shih Hao
AU - Tseng, Sung Huei
AU - Huang, Fu-Chin
AU - Lai, Chun Chieh
AU - Chen, Ching Lung
AU - Lai, Chien Hsiung
AU - Chen, Po-Lin
AU - Jou-Chen Huang, Evelyn
N1 - Funding Information:
This study was supported by a grant from National Cheng Kung University Hospital , Tainan, Taiwan ( NCKUH-10604009 and NCKUH-10702002 to J.H. Hung).
Publisher Copyright:
© 2019
PY - 2020/10
Y1 - 2020/10
N2 - 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.
AB - 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.
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U2 - 10.1016/j.jmii.2018.12.011
DO - 10.1016/j.jmii.2018.12.011
M3 - Article
C2 - 30661953
AN - SCOPUS:85060090792
SN - 1684-1182
VL - 53
SP - 766
EP - 777
JO - Journal of Microbiology, Immunology and Infection
JF - Journal of Microbiology, Immunology and Infection
IS - 5
ER -