Microbiological Spectrum and Antibiotic Sensitivity in Endophthalmitis

Gentile, Ronald C.; Shukla, Salil; Shah, Mahendra; Ritterband, David C.; Engelbert, Michael; Davis, Andrew S.; Hu, Dan‐Ning

doi:10.1016/j.ophtha.2014.02.001

Cited by 170 publications

(151 citation statements)

References 37 publications

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“…Consistent with other reports, gram-positive organisms were the predominant pathogens, and Staphylococcus species remained to be the most common infectious organisms. 1,[9][10][11][12][13][14] The differences between this and previous reports included the present observation of a larger proportion of fungi than gram-negative organisms (18.4 vs.16.6) and the decrease in gram-negative organisms from 32% to 11% (P = 0.019) and increase in the percentage of gram-positive bacteria from 49% to 73% (P = 0.174) over a 10-year period, which disagree with the findings of a study by Gentile et al 15 The reasons for this difference remain unclear. Factors influencing variation between multiple reported studies include the period in time analyzed, prevalence of predisposing illnesses, geographic factors in organism incidence, urban versus rural settings, ethnicity, outpatient versus inpatient populations especially those in tertiary care centers, and climatic factors.…”

Section: Discussioncontrasting

confidence: 99%

“…In our study, gram-positive organisms identified were generally susceptible to vancomycin, which is consistent with previous reports. 15,21 The susceptibility of the gram-negative organisms to ceftazidime was 50.5%, which is prescribed as initial empirical therapy for gram-negative bacteria. The susceptibility of the gram-negative organisms to ciprofloxacin was higher than that to ceftazidime, which parallels the results of a previous study 3,4 but disagrees with the finding of Gentile et al 15 that 90% of the gram-negative organisms were susceptible to ceftazidime.…”

Section: Discussionmentioning

confidence: 99%

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Microbiological Isolates and Antibiotic Susceptibilities: A 10-Year Review of Culture-Proven Endophthalmitis Cases

Liu

et al. 2016

Current Eye Research

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Microbiological Isolates and Antibiotic Susceptibilities: A 10-Year Review of Culture-Proven Endophthalmitis Cases

Liu

et al. 2016

Current Eye Research

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“…5,6 Solomon et al reported an incidence of one infection for every 2,131 refractive surgery procedures in 2004, which increased to an incidence of one infection every 1,102 procedures in 2011; MRSA was the most common organism cultured. 5 High levels of methicillin resistance were also reported for S. aureus (51.9%) and S. 8 MRSA infection and other multidrug-resistant bacterial pathogens can be detrimental to vision and represent a major therapeutic challenge. 3,9 There is a paucity of studies that monitor antibiotic resistance among ocular bacteria, and this represents a substantial unmet need.…”

mentioning

confidence: 99%

Antibiotic Resistance Trends Among Ocular Pathogens in the US—Cumulative Results from the Antibiotic Resistance Monitoring in Ocular Microorganisms (ARMOR) Surveillance Study

Asbell¹,

Sanfilippo²

2017

US Ophthalmic Review

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A ntibiotic resistance among ocular pathogens is a public health concern. The multicenter, prospective Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) study is an ongoing surveillance study designed to report on antibiotic resistance rates and trends among Staphylococcus aureus, coagulase-negative staphylococci (CoNS; includes Staphylococcus epidermidis), Streptococcus pneumoniae, Pseudomonas aeruginosa, and Haemophilus influenzae isolates from ocular infections. Results for more than 4,000 isolates collected from 2009 -2015, representing 7 years of ARMOR, were recently presented. More than a third of S. aureus and almost half of all CoNS isolates were found to be resistant to methicillin. Staphylococcal isolates also showed high levels of multidrug resistance (resistance to ≥3 antibacterial drug classes) with 76.4% and 73.7% of methicillin-resistant S. aureus (MRSA) and methicillin-resistant CoNS (MRCoNS) isolates, respectively, demonstrating multidrug resistance. Resistance among S. pneumoniae was notable for azithromycin (36.8%) and for penicillin (34.0%), whereas P. aeruginosa and H. influenzae were generally susceptible to the antibiotic classes tested. Longitudinal analyses demonstrated a small decrease in methicillin resistance among S. aureus over the 7-year study period, which may be a result of improved antibiotic stewardship. Continued surveillance of antibiotic resistance among ocular pathogens is warranted.

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“…Ceftazidime plus vancomycin may be effective antibiotics to treat endophthalmitis (21). The established intravitreal injection dosages for adults are 2.25 mg/0.1 ml ceftazidime and 1.0 mg/0.1 ml vancomycin.…”

Section: Discussionmentioning

confidence: 99%

Early clinical characteristics of bacterial endophthalmitis in retinopathy of prematurity after intravitreal bevacizumab injection: A case report

Wang

Xiang

2017

Experimental and Therapeutic Medicine

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Abstract. Intravitreal bevacizumab injection (IVB) is emerging as a safe and effective therapy for retinopathy of prematurity (ROP); however, follow-up investigations after IVB have indicated that endophthalmitis, a rare and devastating complication, may develop. The present study reports a case of an infant with ROP who developed endophthalmitis after IVB infection. The infant was administered with an intravitreal injection of broad-spectrum antibiotics to treat the endophthalmitis. A favorable anatomic outcome was achieved after follow-up. From this case, it was discovered that the early clinical characteristics of endophthalmitis infection secondary to IVB in premature infants include: i) The clinical symptoms of endophthalmitis infection appearing as early as 3-5 days after IVB; ii) a white membranous plaque on the retina surface with an obscure circular boundary; iii) a plaque that enlarges to a gray flocculent mass and intrudes the vitreous body, where the hazing surrounds the lesion; and iv) conjunctival hyperemia and cornea edema in the anterior segment of the affected eye. This case also indicated that timely retinal screening with RetCam or a binocular ophthalmoscope 3-5 days after IVB may be effective for detecting early stage endophthalmitis in infants who are unable to complain of a loss of visual acuity. From the present case report, it is advisable that the same type of screening be performed 3-5 days after other types of eye surgery, such as cataract extraction surgery, to detect early stage endophthalmitis. Furthermore, the present case also revealed that an early intravitreal injection of broad-spectrum antibiotics may be an effective treatment for premature infants with bacterial endophthalmitis.

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Microbiological Spectrum and Antibiotic Sensitivity in Endophthalmitis

Cited by 170 publications

References 37 publications

Microbiological Isolates and Antibiotic Susceptibilities: A 10-Year Review of Culture-Proven Endophthalmitis Cases

Microbiological Isolates and Antibiotic Susceptibilities: A 10-Year Review of Culture-Proven Endophthalmitis Cases

Antibiotic Resistance Trends Among Ocular Pathogens in the US—Cumulative Results from the Antibiotic Resistance Monitoring in Ocular Microorganisms (ARMOR) Surveillance Study

Early clinical characteristics of bacterial endophthalmitis in retinopathy of prematurity after intravitreal bevacizumab injection: A case report

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