PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 12516720

Do we heed the endophthalmitis vitrectomy study in Canada?

Farhan Siddiqui·Craig Crippen·Cindy M L Hutnik
View original source ↗Export metadata ↓

Abstract

BACKGROUND: The Endophthalmitis Vitrectomy Study (EVS) was a multicentre randomized clinical trial designed to guide the management of postoperative bacterial endophthalmitis. There is speculation that many physicians do not follow its recommendations, despite its intent. We surveyed Canadian vitreoretinal surgeons to determine whether surgeons are adopting the EVS recommendations in their management of bacterial endophthalmitis after cataract surgery. METHODS: A survey was sent to 98 vitreoretinal surgeons across Canada who manage postoperative endophthalmitis following cataract surgery. The survey explored the management of patients presenting with a hypopyon or suspected endophthalmitis, or both, early (up to 2 weeks) after cataract surgery. For purposes of comparison with the EVS, the questions were divided into presenting visual acuity categories. RESULTS: Of the 98 surgeons 30 (30.6%) responded to the survey. The preferred treatment for patients presenting with no light perception visual acuity was pars plana vitrectomy (23 respondents [76.7%]); 7 respondents (23.3%) preferred vitreous tap/biopsy. All but one of the respondents stated that they prefer pars plana vitrectomy for patients presenting with light perception vision; the remaining physician preferred either pars plana vitrectomy or vitreous tap/biopsy. For patients with hand motions visual acuity, 17 respondents (56.7%) would perform pars plana vitrectomy, 11 (36.7%) would perform vitreous tap/biopsy, and 2 (6.7%) would perform either procedure. Most of the respondents (20 [66.7%]) would perform vitreous tap/biopsy for patients with visual acuity of counting fingers, whereas 9 (30.0%) would perform pars plana vitrectomy, and 1 (3.3%) would perform either procedure. All the respondents indicated that they would use intraocular antibiotic therapy for initial treatment, 29 (96.7%) would use topical antibiotic therapy, 17 (56.7%) would inject antibiotics subconjunctivally, and 1 (3.3%) would use intravenous antibiotic therapy. Fourteen respondents (46.7%) would use intraocular steroid therapy. INTERPRETATION: Most of the Canadian vitreoretinal surgeons who responded to this survey do not follow the recommendations of the EVS.

Explore related subjects

Anti-Bacterial AgentsBiopsyCanadaCataract ExtractionEndophthalmitisEye Infections, BacterialHealth SurveysHumansPostoperative ComplicationsPractice Guidelines as TopicPractice Patterns, Physicians'Randomized Controlled Trials as TopicVisual AcuityVitrectomyJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Farhan Siddiqui, Craig Crippen, Cindy M L Hutnik. 2002. Do we heed the endophthalmitis vitrectomy study in Canada?. https://doi.org/10.1016/s0008-4182(02)80041-2

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2026

Total Synthesis and Structural Revision of Rhabdobranin Reveals a Cryptic Gram-Negative Antibiotic.

Gram-negative bacteria present a major clinical challenge but also remain an underexplored source of antibacterial natural products. Resistance-guided genome mining of the entomopathogenic symbiont Xenorhabdus identified the rdb biosynthetic gene cluster, which encodes a putative prodrug antibiotic, pre-rhabdobranin. However, the inability to isolate the proposed active metabolite, rhabdobranin, has prevented direct functional evaluation. Here we report a convergent total synthesis of the proposed structure of pre-rhabdobranin B, which revealed a stereochemical misassignment at the N-terminal arginine residue. Synthesis of both rhabdobranin epimers showed that, although they are nearly indistinguishable by standard analytical methods, inversion at this single stereocenter has a pronounced effect on antibacterial activity. Biological evaluation of the revised rhabdobranin structure revealed potent antibacterial activity against Gram-negative pathogens, including WHO critical-priority carbapenem-resistant Klebsiella pneumoniae. Cellular and biochemical profiling implicated inhibition of protein biosynthesis as its principal antibacterial mechanism. We further show that the GNAT-family acetyltransferase RdbK N-acetylates rhabdobranin, attenuating its activity and establishing a secondary self-resistance mechanism. These findings validate resistance-gene-guided discovery in Gram-negative symbionts as a strategy for uncovering cryptic antibiotics and identify rhabdobranin as a promising scaffold for Gram-negative antibiotic development.

Anti-Bacterial Agents↗
PubMed2026

Environmental antibiotic contamination and AMR: Integrating pathways, impacts, and artificial intelligence-driven mitigation.

The widespread contamination of the environment with antibiotic residues is a significant factor contributing to the global crisis of antimicrobial resistance (AMR). Antibiotics from various sources, such as effluents from municipal and hospital wastewater treatment plants, agricultural runoffs, discharges from pharmaceutical manufacturing and improper disposal of expired or unused medicines, create selective pressures in the spread of antibiotic resistance genes. These environmental reservoirs act as hotspots for horizontal gene transfer, facilitating the emergence of multidrug-resistant pathogens. Conventional detection methods including culture-based assays, chromatographic quantification, and molecular diagnostics, provide essential insights but are limited by low throughput, reduced sensitivity to new Antibiotic Resistance Genes, and challenges in real-time monitoring across complex environments. Recent advances, such as whole-genome sequencing, metagenomics, and biosensor-based detection, help to address these gaps by enabling more comprehensive surveillance of the resistome. Artificial intelligence further enhances these approaches by improving data interpretation and pattern recognition, thus complementing traditional and molecular methods rather than replacing them. This review examines the pathways of environmental antibiotic contamination, ecological and health impacts of AMR, and limitations of conventional detection methods. It aims to clarify how these pathways contribute to the AMR crisis, assess the effectiveness of existing surveillance techniques, and identify gaps in current research.

Anti-Bacterial Agents↗
PubMed2026

Discovery of Glycosylated β-Amino Acid-Containing Macrolactams from Nonomuraea sp. 0L2P via Genome Mining.

β-Amino acid-containing macrolactams (β-AACMs) are a class of bioactive natural products characterized by nitrogen-containing starter units within polyketide-derived macrocycles. Here, we report four previously undescribed macrolactams, gruelactams A-D (1-4), from Nonomuraea sp. 0L2P, discovered through an integrated approach combining genome mining, 15N-labeling, and antibacterial screening. Their planar structures were elucidated by comprehensive spectroscopic analyses, including 1D and 2D NMR and HRESI-MS, and their configurations were partially assigned based on ROESY data and bioinformatic analysis. Genome sequencing and antiSMASH analysis identified a putative type I polyketide synthase (PKS) biosynthetic gene cluster, enabling the proposal of a biosynthetic pathway. Bioactivity assays showed that gruelactam D (4) exhibits antibacterial activity against Bacillus cereus and Staphylococcus aureus, with MIC values of 8 and 16 μg/mL, respectively. These findings expand the chemical diversity of β-AACMs and demonstrate the utility of genome-guided approaches for discovering bioactive natural products from rare actinomycetes.

Anti-Bacterial Agents↗