Microbiologic spectrum and susceptibility of isolates in delayed post-cataract surgery endophthalmitis

Abstract

The objective of this study was to evaluate the microbiological spectrum and antimicrobial susceptibility of isolates in delayed post-cataract surgery endophthalmitis. A retrospective review of 33 consecutive patients with culture proven delayed post-cataract surgery endophthalmitis was done from January 2006 to March 2013. There were 22 bacterial and eleven fungal cases. Common isolates were Streptococci (seven cases), coagulase-negative staphylococci (five), Gram-negative bacilli (seven), Nocardia (two), Aspergillus (five), Candida (five). Gram-positive cocci were most susceptible to vancomycin and gatifloxacin (91.7%). Gram-negative isolates were most susceptible to ofloxacin (85.7%). Fungi being slow growing organisms are an important cause of delayed post-cataract surgery endophthalmitis.

Clinical Profile, Antibiotic Resistance and Outcomes in Bacterial Endophthalmitis: Coagulase-Negative Staphylococcus Endophthalmitis as Compared to Other Organisms

“…Among these four were coagulase-negative Staphylococcus. A study from India on delayed-onset PCE found only 70% of the gram-negative isolates to be susceptible to ceftazidime [ 33 ]. A study over 14 years on PTE patients found 77% of gram-negative isolates to be susceptible to ceftazidime, with a very high susceptibility of gram-positive organisms to vancomycin [ 16 ].…”

Update on the epidemiology and antibiotic resistance of ocular infections

“…Gram-positive isolates, predominantly CoNS, remain the most common isolates recovered from endophthalmitis. [ 22 23 24 ] The spectrum and diversity is expanding and varies dependent on endophthalmitis category.…”

Propionibacterium acnes–associated Delayed-onset Pseudophakic Endophthalmitis

“…In 3 of 4 large case review series, P. acnes was the most isolated microbiological cause of delayed-onset postoperative endophthalmitis after cataract surgery. [1][2][3]48 48 however, did not report any culture-positive cases of P. acnes. In their review of 33 cases of culture-positive delayed-onset endophthalmitis after cataract surgery, 36% (12/33) were positive for gram-positive cocci, 3% (1/33) was positive for gram-positive bacillus, 21% (7/33) were positive for gram-negative bacteria, 6% (2/33) were positive for Nocardia, and an impressive 33% (11/33) were positive for fungi.…”

“…In 3 of 4 large case review series, P. acnes was the most isolated microbiological cause of delayed-onset postoperative endophthalmitis after cataract surgery 1–3,48. Fox, Al-Mezanine, and Shirodkar identified P. acnes in samples from 63% (12/19), 41% (7/17), and 42% (11/26) culture-positive cases, respectively.…”