Abstract ID: 26-480
Orbital Abscess Microbiology in the United Kingdom: A Multicentre comparative study of temporal changes and age-based cohorts
Author: Balazs Fazekas Base Hospital / Institution: QMC – Nottingham – United Kingdom
Presentation Type: Rapid Fire Presentation Session: Trauma / War / MiscellaneousDate: 11th SeptemberTime: 09.03AM
Purpose
To determine the pathogens isolated from orbital abscesses and their antimicrobial sensitivity patterns around the United Kingdom, with analysis of temporal trends and comparisons among three age-defined cohorts.
Methods
A retrospective review was undertaken of patients who underwent surgical drainage of orbital collections at six tertiary centres around the United Kingdom from June 2005 to December 2025. Culture results were analysed overall, and comparatively following categorisation into paediatric, adolescent and adult cohorts, as well as pre- and post-Covid time periods.
Results
In total, cultures from 147 patients with surgically-treated orbital cellulitis were included. The study comprised 50 paediatric patients, 42 adolescents and 55 adults. Organisms were cultured in 86 patients (58.5%), of which 20 (13.6%) had polymicrobial infections. The three most common organisms were Streptoccus milleri (n=27, 18.4%), Streptococcus pyogenes (n=20, 13.6%) and Methicillin-sensitive Staphylococcus aureus (MSSA) (n=11, 7.5%). Methicillin-resistant Streptococcus aureus (MRSA) accounted for 3 (2.0%) separate infections. Polymicrobial cultures and anaerobic organisms were more common in adult cohorts. Streptococcus pyogenes were almost exclusively found in the Paediatric population (36% vs 2.4% in adolescents, 1.8% in adults, p <0.001). Analysis showed a trend towards reduced prevalence Streptococcus pyogenes and increased prevalence of MSSA (p = 0.052, p=0.0589 respectively) in the post-Covid period. Our study supports the use of co-amoxiclav as 1st line of empirical antibiotic choice, as this would provide effective antimicrobial cover for the majority of the most commonly isolated pathogens.
Conclusion
To our knowledge, this is the largest series of surgically-drained orbital abscess microbiology profiles in the UK. Over the last 20 years there has been a predominance of Streptococcus species isolated. Older age-groups were associated with polymicrobial growth and anaerobic organisms. Our study did not find significant changes in the organism profile pre- and post-Covid pandemic.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Mohamed | Morgan (Joint 1st author) | QMC- Nottingham |
| Katya | Tambe | QMC- Nottingham |
| Malik | Moledina | Hillingdon Hospitals – UK |