Postoperative endophthalmitis and Stenotrophomonas maltophilia: A case series highlighting the risks of reused surgical equipment

Postoperative endophthalmitis is a serious complication with significant visual consequences. While common pathogens are usually involved, rare organisms such as Stenotrophomonas maltophilia can also cause this condition. Identifying and treating the source of infection is critical for improving outcomes. We report three cases of acute postoperative endophthalmitis occurring within the same week. All patients underwent pars plana vitrectomy (PPV) with vitreous sampling, followed by empiric treatment with systemic and topical moxifloxacin and systemic trimethoprim-sulfamethoxazole, adjusted according to culture sensitivities. Two patients responded well to PPV and medical therapy but a diabetic patient required intravitreal injections and intraocular lens explantation. The probable source of infection was reused phacoemulsification device cassette. This case series highlights the need for strict infection control practices and disposable devices to prevent postoperative infections caused by atypical pathogens such as S. maltophilia.