Skip Navigation LinksHome > February 2014 - Volume 34 - Issue 2 > CHANGING PROFILE OF ORGANISMS CAUSING SCLERAL BUCKLE INFECTI...
Retina:
doi: 10.1097/IAE.0b013e3182979e4a
Original Study

CHANGING PROFILE OF ORGANISMS CAUSING SCLERAL BUCKLE INFECTIONS: A Clinico-microbiological Case Series

Mohan, Neha MS*; Kar, Sarita MSc; Padhi, Tapas Ranjan MS*; Basu, Soumyava MS*; Sharma, Savitri MD; Das, Tara Prasad MD*

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Abstract

Purpose:

To study the microbiological spectrum and in vitro susceptibility of bacterial isolates from explanted scleral buckles and to correlate clinical presentation to the causative agent.

Method:

Medical records of patients who underwent buckle explantation from July 2007 to May 2012 were reviewed retrospectively. Clinical features and microbiological profile were noted and correlated.

Results:

Twenty of 24 buckles (83.33%) from 24 patients grew 21 isolates. Isolates included 6 acid-fast bacilli (28.57%; atypical mycobacteria = 5, Nocardia asteroides = 1), 5 gram-positive bacilli (23.8%; Corynebacterium spp. = 4, Bacillus sp. = 1), 4 gram-positive cocci (19.0%; Staphylococcus spp. = 4), 2 gram-negative bacilli (9.5%; Pseudomonas aeruginosa = 2), and 4 fungi (19.0%; Aspergillus spp. = 3, Paecilomyces sp. = 1). Acid-fast bacilli and gram-negative bacilli were sensitive to amikacin and gram-positive bacilli and gram-positive cocci to vancomycin. Buckle exposure within 2 years of primary surgery tended to be noninfective (P = 0.06). Fungal or mycobacterial infections were more symptomatic than those with Corynebacterium species. Results of microscopic examination of conjunctival swab in 5 of 7 eyes (71.4%) were consistent with culture of conjunctival swab and explanted buckles.

Conclusion:

Clinical features and microscopic examination of conjunctival swab may give a lead toward the causative organism in suspected buckle infections. Based on these leads, vancomycin and amikacin may be used as the initial empirical therapy.

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