Microbiological Landscape and Epidemiology of Endophthalmitis in Children and Adolescents in a Multi-Tier Ophthalmology Network in India: An Electronic Medical Record-Driven Analytics Report

To study the epidemiology and microbiological landscape in patients (≤21 yrs) diagnosed with endophthalmitis across a multi-tier ophthalmology network in India. This cross-sectional hospital-based study included 1,041 patients (≤21 yrs) diagnosed with endophthalmitis, between April 2012 and May 2022. The data were collected using an electronic medical record system. Bacteria (24%) was the most common etiology followed by fungus (2%). The majority of the patients were male (66%) with a mean age of 8.37 ± 5.99 years. The most common age group was middle childhood (6-11 years) with 365 (35.06%) patients. The patients were more commonly from the lower socio-economic status (60.81%) and urban geography (49%). The common cause of endophthalmitis was trauma (59.33%) and amongst the 279 culture positive eyes, the predominant bacteria isolated was Streptococcus pneumoniae followed by Bacillus species and fungus included predominantly Aspergillus and Candida species. The most common surgical intervention performed was intraocular antibiotics (74%) followed by pars plana vitrectomy (52%). The most common etiology of endophthalmitis in children is bacterial and traumatic in nature and presented from the lower socio-economic status. A half of the eyes warranted a vitreo-retinal surgical intervention.       A cross-sectional study on the microbiological landscape in pediatric endophthalmitis showed that the most common cause of endophthalmitis was trauma and the predominant bacteria isolated was Streptococcus spp. and Bacillus spp. Additionally, majority of the patients were from the lower socio-economic status and urban geography and the most common surgical intervention performed was injection of intraocular antibiotics.

本研究旨在探究印度多层级眼科网络中，21岁及以下确诊为眼内炎患者的流行病学和微生物学特征。这是一项基于医院的横断面研究，纳入了2012年4月至2022年5月间确诊的1041名（≤21岁）眼内炎患者。数据通过电子病历系统收集。最常见的病因是细菌感染（24%），其次是真菌感染（2%）。大多数患者为男性（66%），平均年龄为8.37 ± 5.99岁。最常见的年龄段为学龄前期（6-11岁），共有365名（35.06%）患者。患者中来自较低社会经济地位（60.81%）和城市地区（49%）的比例较高。眼内炎的最常见原因为外伤（59.33%），在279个培养阳性的眼中，分离出的主要细菌为肺炎链球菌，其次是芽孢杆菌，真菌则主要包括曲霉菌和念珠菌。最常见的手术干预措施为眼内抗生素注射（74%），其次是玻璃体切除术（52%）。儿童眼内炎的最常见病因是细菌性和创伤性，并主要呈现于较低的社会经济地位。一半的患者需要进行玻璃体视网膜手术。一项关于儿童眼内炎微生物学特征的横断面研究显示，眼内炎最常见的原因是外伤，分离出的主要细菌为链球菌属和芽孢杆菌属。此外，大多数患者来自较低的社会经济地位和城市地区，最常见的手术干预措施为眼内抗生素注射。