Isolates and antibiotic susceptibilities of endophthalmitis in postcataract surgery: a 12-year review of culture-proven cases

Abstract

The purpose of this study was to investigate the spectrum of organisms causing endophthalmitis after cataract surgery in a tertiary medical center in Taiwan and the antibiotic susceptibilities. This was a retrospective case series study. Patients with endophthalmitis after cataract surgery from January 2004 to July 2015 were reviewed. The outcome measures included the identification of isolates, antibiotic susceptibilities, and final visual outcomes. Twenty-one organisms were isolated from 19 cases. The most common organisms were Enterococcus in 38.1 %, especially Enterococcus faecalis, followed by Staphylococcus epidermidis in 28.6 % and Staphylococcus aureus in 9.5 %. All of the Gram-positive isolates tested were susceptible to vancomycin (100 %), and ceftazidime and amikacin were susceptible for Gram-negative organisms. The Gram-positive organisms remain to be the predominant cause of postoperative endophthalmitis, and Enterococcus species has had an increasing incidence. Vancomycin is still the most powerful antibiotic for Gram-positive organisms, while ceftazidime and amikacin are effective for Gram-negative bacteria.

In vitro Susceptibilities of Methicillin-Susceptible and Resistant Staphylococci to Traditional Antibiotics Compared to a Novel Fluoroquinolone

“…Similar to prior studies, vancomycin was effective against all 45 isolates in this study, and it remains one of the most effective empiric treatments for endophthalmitis [5,6,9,10,24]. However, delafloxacin has the benefit of wider microbial coverage including Gram-negative organisms like P. aeruginosa, anaerobes, and atypical infections [25,26].…”

“…Of 45 total isolates identified between 2014 and 2018, 13% (6) were methicillin-resistant S. aureus (MRSA), 9% (4) were methicillin-sensitive S. aureus (MSSA), 53% (24) were methicillin-resistant S. epidermidis (MRSE), and 24% (11) were methicillin-sensitive S. epidermidis (MSSE, see Table 1). Among the fluoroquinolones, resistance rates across all organisms were 60% for levofloxacin, 50% for moxifloxacin, and 12% for delafloxacin (see Table 1).…”

Endophthalmitis After Clear Corneal Cataract Surgery: Outcomes Over Two Decades

“…Furthermore, the series was predominantly Enterococcus (38%). 6 Although vancomycin resistant organisms have been described post-cataract surgery, they remain rare. 7 The use of intracameral antibiotics at the time of cataract surgery (vancomycin, cephalosporins, or fluoroquinolones) is controversial.…”

Emerging Enterococcus isolates in postoperative endophthalmitis by selection pressure of fluoroquinolones: an 11-year multicenter and experimental study

“…However, in addition to South Korea, the incidence of Enterococcus spp. has been increasing in Sweden, Japan, and Taiwan [4,7,8,21]. A recent report in Taiwan showed that Enterococcus spp.…”

“…Recently, Enterococcus spp. have emerged as a major causative strain of PE in Sweden, Korea, and Taiwan [4,7,8]. The reason underlying the increase of Enterococcus spp.…”