Microbial Spectrum and Resistance Patterns in Endophthalmitis: A 21-Year (1988–2008) Review in Northeast United States
- 1 August 2012
- journal article
- research article
- Published by Mary Ann Liebert Inc in Journal of Ocular Pharmacology and Therapeutics
- Vol. 28 (4), 329-334
- https://doi.org/10.1089/jop.2011.0204
Abstract
Purpose: To study the microbial spectrum and antibacterial susceptibility of vitreous cultures in a tertiary referral center in Northeast United States. Methods: All vitreous samples sent to the microbiology laboratory at a tertiary referral center from January 1988 to December 2008 were included in the study. The distribution and antibiotic susceptibility of all isolates from culture-positive samples were compared across 3 equal time periods 1988–1994, 1995–2001, and 2002–2008. Results: One hundred forty-three positive cultures, where 11.9% (n=17) were polymicrobial, yielded a total of 160 isolates that consisted of 80.6% (n=129) gram-positive isolates, 12.5% (n=20) gram-negative isolates, and 6.9% (n=11) fungal isolates. The most prevalent organisms were coagulase-negative Staphylococcus (CoNS) (37.5%, n=60), Viridans Streptococcus (11.3%, n=18), and Streptococcus pneumoniae (6.9%, n=11). Other common gram-positive isolates include Propionibacterium acnes (5.6%, n=9), other Streptococcus species (4.4%, n=7), Staphylococcus aureus (4.4%, n=7), and Enterococcus faecalis (3.8%, n=6). The most common gram-negative isolates were Klebsiella species (3.1%, n=5), Moraxella species (3.1%, n=5), and Haemophilus species (2.5%, n=4). Vancomycin was effective against all CoNS, Sta. aureus, Viridans Streptococcus, and E. faecalis tested, and all Sta. aureus isolates were oxacillin sensitive. Of all CoNS isolates, 83.3% during 1988–1994, 73.1% during 1995–2001, and 100% during 2002–2008 were resistant to at least 1 of the antibiotics tested in the study with the last time period showing an increase in resistance (P=0.021, adjusted standard residual=2.0). CoNS showed a decreasing resistance over time to chloramphenicol and gentamicin (P=0.010, P=0.007, respectively) and an increase in resistance to penicillin and tetracycline during 2002–2008 (P=0.003, P=0.040, respectively). Susceptibility to other antibiotics did not show significant dependence on time. Conclusion: Bacteria causing endophthalmitis showed variable resistance to antibiotics over time. The importance of adequately treating endophthalmitis in the setting of these resistance pattern changes stresses the importance of periodic evaluation of causative organisms to ensure appropriate empiric treatment.Keywords
This publication has 12 references indexed in Scilit:
- Microbial profile and antibiotic susceptibility of culture-positive bacterial endophthalmitisEye, 2011
- Endophthalmitis: Pathogenesis, clinical presentation, management, and perspectivesClinical Ophthalmology, 2010
- VITREAL PENETRATION OF ORAL MOXIFLOXACIN IN HUMANSRetina, 2008
- Postoperative Vancomycin-Resistant Enterococcus faecium EndophthalmitisAmerican Journal of Ophthalmology, 2007
- Spectrum of Eye Disease Caused by Methicillin-Resistant Staphylococcus AureusAmerican Journal of Ophthalmology, 2007
- Acute Endophthalmitis Following Cataract SurgeryAmerican Journal of Ophthalmology, 2005
- Changing Trends in the Microbiologic Aspects of Postcataract EndophthalmitisAmerican Journal of Ophthalmology, 2005
- Ciprofloxacin and levofloxacin resistance among methicillin-sensitive staphylococcus aureus isolates from keratitis and conjunctivitisAmerican Journal of Ophthalmology, 2004
- ENDOGENOUS ENDOPHTHALMITIS SECONDARY TO VANCOMYCIN-RESISTANT ENTEROCOCCI INFECTIONRetina, 2003
- Spectrum and Susceptibilities of Microbiologic Isolates in the Endophthalmitis Vitrectomy StudyAmerican Journal of Ophthalmology, 1996