{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T19:11:02Z","timestamp":1793214662045,"version":"4.5.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>\n                      To present varied clinical presentations, surveillance reports, and final visual outcomes of a rare outbreak of cluster endophthalmitis caused by gram-negative, opportunistic bacilli,\n                      <jats:italic toggle=\"yes\">Burkholderia cepacia<\/jats:italic>\n                      complex (Bcc).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Details of five patients who developed postoperative cluster endophthalmitis were collected. For each patient, an undiluted vitreous sample was collected during vitreous tap. Bacterial culture from the vitreous sample in each case had grown Bcc. Surveillance investigations for root cause analysis (RCA) were performed in the operating room (OR), admission, and day-care wards to localize the source.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Four patients had undergone phacoemulsification surgery, and one patient had undergone penetrating keratoplasty. Each patient received an initial dose of empiric intravitreal ceftazidime and vancomycin. The organism isolated in each case was sensitive to ceftazidime, cotrimoxazole, and meropenem and resistant to other antibiotics. Core vitrectomy was done after 48\u201360 hours in four patients along with intravitreal imipenem injection. One patient did not provide consent for core vitrectomy and subsequently developed phthisis bulbi. Three patients had subsequent recurrences. Two patients had a final BCVA of 20\/60, two had BCVA better than 20\/200, while one patient had no perception of light. None of the surveillance samples from the OR complex could isolate\n                      <jats:italic toggle=\"yes\">Burkholderia<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Extensive OR surveillance should be done to identify the potential source of infection. However, the source may not be identifiable in few instances like in our case. Longer follow-up is recommended in cases of Bcc endophthalmitis due to the persistent nature of the infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1035_21","type":"journal-article","created":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T06:00:43Z","timestamp":1640584843000},"page":"164-170","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":13,"title":["Clinical profile, visual outcome and root cause analysis of post-operative cluster endophthalmitis due to Burkholderia cepacia complex"],"prefix":"10.4103","volume":"70","author":[{"given":"Amit Kumar","family":"Deb","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratima","family":"Chavan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subashini","family":"Kaliaperumal","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujatha","family":"Sistla","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Jawaharlal Institute Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haritha","family":"Madigubba","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Jawaharlal Institute Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandip","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aswathi","family":"Neena","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,12,23]]},"reference":[{"key":"B1-20240828","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1136\/bjophthalmol-2013-304129","article-title":"Postoperative endophthalmitis due to Burkholderia cepacia complex from contaminated anaesthetic eye drops","volume":"98","author":"Lalitha","year":"2014","journal-title":"Br J Ophthalmol"},{"key":"B2-20240828","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1016\/j.jcrs.2011.06.018","article-title":"Prevention, diagnosis, and management of acute postoperative bacterial endophthalmitis","volume":"37","author":"Packer","year":"2011","journal-title":"J Cataract Refract Surg"},{"key":"B3-20240828","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.4103\/ijo.IJO_502_20","article-title":"Management of cluster endophthalmitis does not stop at clinical care","volume":"68","author":"Das","year":"2020","journal-title":"Indian J Ophthalmol"},{"key":"B4-20240828","doi-asserted-by":"crossref","first-page":"157","DOI":"10.4103\/0301-4738.39126","article-title":"Clinical profile and visual outcome in cluster endophthalmitis following cataract surgery in Central India","volume":"56","author":"Malhotra","year":"2008","journal-title":"Indian J Ophthalmol"},{"key":"B5-20240828","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.4103\/ijo.IJO_1612_19","article-title":"Post-cataract surgery cluster endophthalmitis due to multidrug-resistant Pseudomonas aeruginosa:A retrospective cohort study of six clusters","volume":"68","author":"Parchand","year":"2020","journal-title":"Indian J Ophthalmol"},{"key":"B6-20240828","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1097\/IAE.0b013e31820a6a03","article-title":"Burkholderia cepacia endophthalmitis:Clinico-microbiologic profile and outcomes","volume":"31","author":"Sachdeva","year":"2011","journal-title":"Retina"},{"key":"B7-20240828","first-page":"100","article-title":"Clinical and laboratory standards institute","volume":"31","author":"Wayne","year":"2011","journal-title":"Performance standards for antimicrobial susceptibility testing"},{"key":"B8-20240828","doi-asserted-by":"crossref","first-page":"673","DOI":"10.4103\/ijo.IJO_509_17","article-title":"A literature review and update on the incidence and microbiology spectrum of postcataract surgery endophthalmitis over past two decades in India","volume":"65","author":"Lalitha","year":"2017","journal-title":"Indian J Ophthalmol"},{"key":"B9-20240828","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s40942-018-0138-7","article-title":"Burkholderia cepacia, a cause of post pars plana vitrectomy silicone oil related endophthalmitis:Clinico-pathological presentation and outcome of management","volume":"4","author":"Okonkwo","year":"2018","journal-title":"Int J Retina Vitreous"},{"key":"B10-20240828","first-page":"3","article-title":"Burkholderia cepacia:A cause of post-operative endophthalmitis","volume":"2","author":"Okonkwo","year":"2019","journal-title":"J Eye Vis"},{"key":"B11-20240828","doi-asserted-by":"crossref","first-page":"504","DOI":"10.4103\/jovr.jovr_194_16","article-title":"Burkholderia cepacia endophthalmitis:An unusual presentation","volume":"13","author":"Deka","year":"2018","journal-title":"J Ophthalmic Vis Res"},{"key":"B12-20240828","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/j.ophtha.2011.09.031","article-title":"An outbreak of acute post-cataract surgery Pseudomonas sp. endophthalmitis caused by contaminated hydrophilic intraocular lens solution","volume":"119","author":"Ramappa","year":"2012","journal-title":"Ophthalmology"},{"key":"B13-20240828","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1136\/bjo.2009.177709","article-title":"A cluster of acute-onset postoperative endophthalmitis over a 1-month period:Investigation of an outbreak caused by uncommon species","volume":"95","author":"Ak\u00e7akaya","year":"2011","journal-title":"Br J Ophthalmol"},{"key":"B14-20240828","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1086\/598938","article-title":"An outbreak of postoperative gram-negative bacterial endophthalmitis associated with contaminated trypan blue ophthalmic solution","volume":"48","author":"Sunenshine","year":"2009","journal-title":"Clin Infect Dis"},{"key":"B15-20240828","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/0035-9203(95)90545-6","article-title":"An outbreak of Pseudomonas aeruginosa postoperative endophthalmitis caused by contaminated intraocular irrigating solution","volume":"89","author":"Swaddiwudhipong","year":"1995","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"B16-20240828","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ajic.2011.02.007","article-title":"Post\u2012cataract surgery endophthalmitis outbreak caused by multidrug-resistant Pseudomonas aeruginosa","volume":"40","author":"Maltezou","year":"2012","journal-title":"Am J Infect Control"},{"key":"B17-20240828","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1086\/502272","article-title":"Epidemiologic investigation of Burkholderia cepacia acquisition in two pediatric intensive care units","volume":"24","author":"Loukil","year":"2003","journal-title":"Infect Control Hosp Epidemiol"},{"key":"B18-20240828","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/j.ajic.2010.12.005","article-title":"Outbreak of Burkholderia cepacia complex among ventilated pediatric patients linked to hospital sinks","volume":"39","author":"Lucero","year":"2011","journal-title":"Am J Infect Control"},{"key":"B19-20240828","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1086\/503343","article-title":"Sustained endemicity of Burkholderia cepacia complex in a pediatric institution, associated with contaminated ultrasound gel","volume":"27","author":"Jacobson","year":"2006","journal-title":"Infect Control Hosp Epidemiol"},{"key":"B20-20240828","first-page":"383","article-title":"Microbial diversity in pharmaceutical product recalls and environments","volume":"61","author":"Jimenez","year":"2007","journal-title":"PDA J Pharm Sci Technol"},{"key":"B21-20240828","first-page":"90","article-title":"Pseudomonas aeruginosa\u2013related postoperative endophthalmitis linked to a contaminated phacoemulsifier","volume":"120","author":"Hoffmann","year":"2002","journal-title":"Arch Ophthalmol"},{"key":"B22-20240828","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/1476-0711-4-19","article-title":"High-resolution genotyping of Pseudomonas aeruginosa strains linked to acute post cataract surgery endophthalmitis outbreaks in India","volume":"4","author":"Kenchappa","year":"2005","journal-title":"Ann Clin Microbiol Antimicrob"},{"key":"B23-20240828","doi-asserted-by":"crossref","first-page":"2321","DOI":"10.1016\/j.ophtha.2009.06.004","article-title":"An outbreak of post-cataract surgery endophthalmitis caused by Pseudomonas aeruginosa","volume":"116","author":"Pinna","year":"2009","journal-title":"Ophthalmology"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijo.IJO_1035_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:10:22Z","timestamp":1787771422000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijo.IJO_1035_21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,23]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_1035_21","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,23]]},"assertion":[{"value":"2021-04-30","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-25","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}