Xanthomonas maltophilia Endophthalmitis After Cataract Extraction

Co‐existence of Staphylococcus spp and Stenotrophomonas maltophilia infection in persistent endophthalmitis after cataract surgery

“…Other researchers who reported post-surgical endophthalmitis with S. maltophilia confirmed its resistance to antibiotics, such as ciprofloxacin, ceftriaxone, cefuroxime, ceftazidime, ampicillin, imipenem, amicacin, tobramycin, and gentamicin. [5][6][7][8][9] It is possible that initially the bacteria were susceptible to intravitreal antibiotic injections, hence the remissions of inflammation. We assume that several years of treatment with various antibiotics, whether systemic, subconjunctival, peribulbar or finally intravitreal, triggered resistance to antibiotics.…”

“…10 There are several described cases of post-surgical endophthalmitis caused by S. maltophilia. In two-thirds of the cases, the inflammation could be controlled without recurrence, using only intravitreous injections with antibiotics; 5,6,9 vitrectomy was necessary in several cases [6][7][8] and an artificial lens was removed from three eyes. 7,9 Final visual acuity was satisfactory in the majority of cases, from 6/15 to 6/6, although in several eyes vision was poor, 6/30 or less.…”

“…A similar observation was made by Karakurt 9 concerning a patient with ruptured posterior capsular bag. Other authors [5][6][7][8][9] reported the development of inflammation from three to 30 days after surgery.…”

Outbreak of Empedobacter brevis endophthalmitis after cataract extraction

“…Such clusters are interesting as they reveal how variable the response to the same bacterium may be. Neither case reports [3,4,9,11,16] nor multicentre studies [1] permit analysis and comparison of different patients' response to one and the same pathogen.…”

Stenotrophomonas

“…................................................................................... S. maltophilia has been implicated as a direct agent of disease and as the cause of secondary infections that aggravate various human pathological conditions. It has been identified in cystic fibrosis (Gladman et al, 1992;Denton et al, 1996), cancer (Khardori et al, 1990;Elsner et al, 1997), meningitis (Nguyen and Muder, 1994;Papadakis et al, 1997), soft tissue infections (Vartivarian et al, 1994), septic bursitis (Papadakis et al, 1996), urinary tract infections (Vartivarian et al, 1996), bacteremia (Muder et al, 1996), endophthalmitis following surgical procedures (Kaiser et al, 1997), and pneumonia (Elsner et al, 1997). The literature records concern for the emergence of the species as a dangerous opportunistic pathogen (Marshall et al, 1989), and for the role of anti-pseudomonadal antibiotics in this process.…”