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

Ocul Immunol Inflamm. 2024 Jan 19:1-7. doi: 10.1080/09273948.2023.2298932. Online ahead of print.

Abstract

Purpose: To study the epidemiology and microbiological landscape in patients (≤21 yrs) diagnosed with endophthalmitis across a multi-tier ophthalmology network in India.

Methods: 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.

Results: 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%).

Conclusion: 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. .

Keywords: Big data; India; electronic medical records; endophthalmitis; ocular microbiology.

Plain language summary

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.