Causative Agents of Endophthalmitis in Turkey: An Overview

Abstract

Endophthalmitis is described as bacterial and fungal infections of the vitreous and aqueous humor. It is the result of exogenous or endogenous contamination by microorganisms. Exogenous contamination results from ocular surgery and trauma while endogenous contamination results from microorganisms gaining access via bloodstream. Sterile endophthalmitis may result from various causes such as retained native lens material after an operation or toxic agents. Most of endophthalmitis cases are acute and require urgent medical attention. Delayed or inadequate treatment can result in irreversible loss of vision. Application of the proper treatment protocol against defined infectious agent increases success of the treatment. It is important to start the treatment against possible infectious agents particularly in patients requiring urgent attention. According to the research of Medline PubMed, ISI Web, Web of Science, Google Academic and Turkish Medline with key words including "endophthalmitis" and "Turkey", the exogenous endophthalmitis agents reported in Turkey are Burkholderia cepacia, Bacillus cereus, Chlamydia trachomatis, Stenotrophomonas maltophilia, Corynebacterium minutissimum, Staphylococcus epidermidis, S. aureus, Pseudomonas spp., Streptococcus pneumoniae, Propionobacterium acnes, Nocardia asteroides, P. aeruginosa, Acinetobacter spp., Cellulosimicrobium cellulans, Ochrobactrum anthropi, coagulase-negative staphylococci, S. pyogenes, alpha-haemolitic streptococci, group G streptococci and Acinetobacter baumannii. Endogenous endophthalmitis agents are diphteroid bacilli, Klebsiella pneumoniae and methicillin susceptible S. aureus. Fungal endophthalmitis agents are Candida albicans, C. pelliculosa, Fusarium solani, Fusarium spp., Aspergillus ustus, A. flavus, and Scopulariopsis spp. There is a wide variety of bacterial agents causing endophthalmitis in Turkey. These bacteria cannot colonize a healthy eye, but they can be transmitted to eye exogenously by operations or trauma. It is important to take maximal sterilization and antisepsis precautions during eye manipulations to prevent from endophthalmitis because microorganisms mentioned above are commonly available in hospital settings. This review evaluated the causative agents of endophthalmitis in Turkey.