Emerging culprit of post-operative cluster endophthalmitis in Eastern India: Acinetobacter baumannii

Abstract

Purpose: To report clinical profile, etiology, management, outcomes and drug sensitivity in Acinetobacter baumannii cluster endophthalmitis. Methods: Four post-surgical cases presented to a tertiary care hospital in eastern India 5 days after manual small incision cataract surgery - two were diabetic with unilateral panophthalmitis and no light perception and two had no systemic diseases, unilateral endophthalmitis with perception of light only. All cases underwent immediate core vitrectomy with intravitreal antibiotics followed by repeat intravitreal antibiotics and anterior chamber wash. Results: A. baumannii sensitive to amikacin was isolated from vitreous in all cases. One patient achieved vision of 6/60, while one patient retained 1/60 vision with clear media and attached retina at final visit. Two eyes with panophthalmitis ended up with phthisis bulbi. Conclusion: A. baumannii is a very rare cause of common source endophthalmitis with poor visual and anatomical outcomes. Prevention through rigorous pre-operative preparation cannot be overemphasized