A cluster of acute-onset postoperative endophthalmitis over a 1-month period: investigation of an outbreak caused by uncommon species

Abstract

The authors are unaware of any previous reports of postoperative endophthalmitis associated with Cellulosimicrobium cellulans. Prompt management with microbiological support, intravitreal antibiotics and PPV when needed were the key to good visual outcomes in this endophthalmitis outbreak.

Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen

“…However, no synergistic effect against these two isolates was observed for the combination of Esc(1-8) and amikacin. No synergy was observed for Esc (1)(2)(3)(4)(5)(6)(7)(8) used in combination with ceftazidime or levofloxacin. In the presence of 20% heat-inactivated human serum, against one representative S. maltophilia isolate, Esc(1-8) demonstrated enhanced bactericidal activity (4 g/ml; 1/8 minimal bactericidal concentration [MBC]) when used in combination with colistin (0.125 g/ml; 1/2 MBC) or with amikacin (1 g/ml; 1/16 MBC).…”

“…In sodium phosphate buffer, Esc(1-8) in combination with amikacin or colistin resulted in synergistic activity against five of six S. maltophilia isolates. Enhanced killing at subbactericidal concentrations [0.5-g/ml concentration of Esc (1)(2)(3)(4)(5)(6)(7)(8) and colistin] was observed for the combination of Esc(1-8) and colistin against two representative S. maltophilia isolates. However, no synergistic effect against these two isolates was observed for the combination of Esc(1-8) and amikacin.…”

“…In the presence of 20% heat-inactivated human serum, against one representative S. maltophilia isolate, Esc(1-8) demonstrated enhanced bactericidal activity (4 g/ml; 1/8 minimal bactericidal concentration [MBC]) when used in combination with colistin (0.125 g/ml; 1/2 MBC) or with amikacin (1 g/ml; 1/16 MBC). The observations of an enhanced killing by subbactericidal concentrations of amikacin following the preincubation of S. maltophilia with Esc (1)(2)(3)(4)(5)(6)(7)(8) suggest that the peptide may reduce the outer membrane permeability barrier of S. maltophilia, resulting in an increase in the uptake of amikacin. That study suggested that the use of Esc(1-8) may be helpful for facilitating the antimicrobial activity of drugs (e.g., aminoglycosides) that have difficulty crossing the cell membranes of S. maltophilia (211).…”

“…The activity of Esc (1)(2)(3)(4)(5)(6)(7)(8) in combination with conventional antibiotics used to treat S. maltophilia infections (amikacin, ceftazidime, colistin, and levofloxacin) has been assessed in synergy studies (211). Synergy studies using five clinical S. maltophilia isolates and S. maltophilia ATCC 13637 were performed in the presence of sodium phosphate buffer and human serum.…”

“…The N-terminal region [Esc (1)(2)(3)(4)(5)(6)(7)(8)] of the esculentin-1b peptide isolated from Rana esculenta skin secretions contains the antimicrobial properties of the peptide (214). Esc(1-18) was effective against MDR S. maltophilia clinical isolates at concentrations of 0.5 M, 8 M, and 16 M needed for a bactericidal effect when tested in sodium phosphate buffer (SPB), in 20% heat-inactivated human serum, and in 40% heat-inactivated human serum, respectively (215).…”