Retrospective single-center study of endogenous endophthalmitis, Northeastern China, 2010-2023

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• Picked for Ophthalmology (paper of the day, 21 September 2026): Intravitreal injection reduces risk of poor visual prognosis

Abstract

OBJECTIVE: To explore the epidemiological characteristics of EnE and the molecular traits of the Klebsiella pneumoniae(KP). METHODS: We revived 40 strains of the KP, utilized whole-genome sequencing technology to understand their molecular epidemiological characteristics. RESULTS: Among 103 EnE patients (69.90% male, 56.31% left eye), vision loss was the chief complaint (96.12%). Extraocular infections were present in 63.11% of patients, most commonly liver abscess (45.00%). KP comprised 81.82% of culture-positive cases. Among 40 KP strains analyzed, 82.5% were hypervirulent KP (hvKP). Phylogenetic analysis revealed the dominance of ST23-K1 lineages. Intravitreal injection was associated with a significantly reduced risk of poor visual prognosis (RR = 0.061, 95%CI: 0.005-0.442) and emerged as an independent protective factor. CONCLUSIONS: The incidence of EnE showed an increasing trend, primarily driven by hvKP ST23-K1. A comprehensive search for systemic infection foci, particularly liver abscesses, is essential. A negative string test result does not exclude hvKP. Timely intravitreal antimicrobial injection is a critical modifiable factor for improving visual prognosis.

Abstract as published, via PubMed.