From the Guidelines
Yes, some organisms that cause endophthalmitis, such as Aspergillus, can spread via air, though this is not the most common transmission route. Endophthalmitis is typically caused by bacteria (like Staphylococcus aureus, Streptococcus species, and Pseudomonas aeruginosa) or fungi (such as Aspergillus and Candida species) [ 1 ]. Fungal pathogens, particularly Aspergillus, can be airborne and may cause endogenous endophthalmitis by first infecting the lungs and then spreading to the eye through the bloodstream [ 1 ]. The most recent and highest quality study, from 2013, suggests that endogenous endophthalmitis is usually caused by organisms most responsible for bloodstream infections, including Aspergillus spp [ 1 ].
Some key points to consider:
- Endophthalmitis can arise either by exogenous introduction of pathogens into the eye following trauma or surgery, or as a result of endogenous introduction of pathogens across the blood-eye barrier [ 1 ].
- Treatment typically involves intravitreal antibiotics like vancomycin and ceftazidime for bacterial cases, or amphotericin B for fungal infections, often combined with systemic antimicrobials [ 1 ].
- Prevention in healthcare settings includes maintaining proper air filtration systems, especially in operating rooms, and following strict aseptic techniques during ocular procedures to minimize the risk of introducing airborne pathogens into the eye.
- The diagnosis of endophthalmitis can be made by aspiration of aqueous or vitreous fluid or via biopsy, and specimens should be examined for a variety of potential pathogens, including bacteria, fungi, and viruses [ 1 ].
Overall, while airborne transmission is not the most common route of infection, it is a possible mechanism by which some organisms, such as Aspergillus, can cause endophthalmitis [ 1 ].
From the Research
Spread of Endophthalmitis
- The organism that causes endophthalmitis can spread through various means, but there is limited information on whether it can spread via air.
- According to the available studies, endophthalmitis can occur after penetrating eye procedures, trauma, or the spread of infection from contiguous structures or via emboli from distant organs 2.
- However, there is no direct evidence to suggest that the organism can spread via air.
Modes of Transmission
- The studies suggest that endophthalmitis can be caused by bacteria or fungi, and the mode of transmission can vary depending on the underlying cause 2, 3.
- For example, endophthalmitis can occur after cataract surgery, intravitreal injections, or other penetrating eye procedures 4, 3.
- However, the role of air as a potential mode of transmission is not explicitly mentioned in the available studies.
Treatment and Management
- The treatment and management of endophthalmitis typically involve the use of antibiotics or antifungals, which can be administered intravitreally or systemically 5, 6.
- The choice of treatment depends on the underlying cause of the infection and the severity of the disease 2, 3.
- However, the available studies do not provide information on whether the organism can spread via air, and therefore, do not discuss the potential implications for treatment and management.