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 <i>Streptococcus pneumoniae</i> followed by <i>Bacillus</i> species and fungus included predominantly <i>Aspergillus and Candida</i> 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 <i>Streptococcus</i> spp. and <i>Bacillus</i> 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级眼科医疗网络内确诊为眼内炎（endophthalmitis）的≤21岁患者的流行病学特征与微生物学特征。本项基于医院的横断面研究纳入了2012年4月至2022年5月期间确诊为眼内炎的1041名≤21岁患者，研究数据通过电子病历系统采集。细菌感染（24%）为最常见的致病病因，其次为真菌感染（2%）。患者以男性为主（66%），平均年龄为8.37±5.99岁。最常见的年龄组为学龄中期（6~11岁），共365例，占比35.06%。多数患者来自社会经济地位较低的群体（60.81%），且居住地为城市地区（49%）。眼内炎的常见诱因为外伤（59.33%）；在279例培养阳性的患眼中，分离出的主要致病菌为肺炎链球菌（*Streptococcus pneumoniae*），其次为芽孢杆菌属（*Bacillus*）菌株；真菌类病原体则以曲霉菌属（*Aspergillus*）和假丝酵母菌属（*Candida*）为主。最常用的手术干预方式为眼内抗生素注射（74%），其次为玻璃体切割术（52%）。儿童眼内炎最常见的致病病因与诱因为细菌性感染及外伤，且患者多来自社会经济地位较低的群体。半数患眼需接受玻璃体视网膜手术干预。

本项针对儿童眼内炎微生物学特征的横断面研究显示，眼内炎最常见的诱因为外伤，分离出的主要致病菌为链球菌属（*Streptococcus* spp.）与芽孢杆菌属（*Bacillus* spp.）菌株。此外，多数患者来自社会经济地位较低的群体且居住地为城市地区，最常用的手术干预方式为眼内抗生素注射。