Streptococcus dominates post-traumatic endophthalmitis in kids

Post-traumatic endophthalmitis in children is most commonly caused by Streptococcus pneumoniae, though the dominant species tends to vary greatly between age groups, a recent study has found. Visual outcomes in infected children remain poor even despite prompt treatment.

The study included 21 patients (aged ≤6 years, 57.1 percent boys) who contributed a total of 21 eyes for analysis. Patients took an average of 2.6 days before undergoing primary repair and stayed in the hospital for an average of 7.6 days.

Twenty-one isolates were available for analysis of the causative microorganism, of which 47.6 percent tested positive for S. pneumoniae and 42.9 percent of viridans group streptococci; two samples contained S. pluranimalium.

However, the dominant causative microorganism changed according to age groups. For example, in 0–3-year-olds, viridans group streptococci were the most common isolates, identified in 58.3 percent of samples. In patients aged 4–6 years, such microorganism group accounted for only 22.2 percent of cases, while S. pneumoniae could explain up to 66.7 percent of cases.

In terms of antibiotic susceptibility, all 21 isolates were susceptible to cefuroxime, while ceftazidime and cefazolin showed susceptibility rates reaching 80 percent. Streptococcus isolates were 100-percent susceptible to chloramphenicol, 95.0 percent to levofloxacin, and 90.5 percent to ofloxacin. Streptococcus susceptibility to penicillin was only 62.5 percent and dropped as low as 18.8 percent to amikacin.

“Both cefuroxime and levofloxacin showed excellent susceptibility and are thus recommended for treatment. Although the infection was under control after prompt treatment upon diagnosis, the vision outcomes were still poor,” the researchers said.