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Pathogens and antibiotic sensitivities in endophthalmitis
Author(s) -
Slean Geraldine R,
Shorstein Neal H,
Liu Liyan,
Paschal John F,
Winthrop Kevin L,
Herrinton Lisa J
Publication year - 2017
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12910
Subject(s) - medicine , endophthalmitis , antibiotics , gatifloxacin , ofloxacin , vancomycin , antibiotic prophylaxis , cataract surgery , antibiotic resistance , antibiotic sensitivity , surgery , microbiology and biotechnology , staphylococcus aureus , ciprofloxacin , bacteria , biology , genetics
Background Antibiotic prophylaxis in cataract surgery is intended to minimize endophthalmitis. We describe pathogenic organisms, antibiotic sensitivities and antibiotic prophylaxis in culture‐proven endophthalmitis cases. Design Retrospective consecutive case series and community‐based setting were used. Participants Two hundred fifteen cases of endophthalmitis after cataract surgery performed during 2007–2012 in Kaiser Permanente, California. Methods and Main Outcome Measures Descriptive analysis of isolated organisms and antibiotic sensitivities in relation to antibiotic prophylaxis in culture‐proven endophthalmitis cases. Results The majority of culture‐confirmed organisms ( n = 83) were Gram positive (96%), most notably coagulase‐negative Staphylococci ( n = 34, 52%), of which all that underwent testing were sensitive to vancomycin ( n = 32). Among 19 cases that had received only topical antibiotic prophylaxis, seven (37%) were resistant to the antibiotic given: 50% of cases (5 of 10 isolates) that had received ofloxacin were resistant to this antibiotic, 40% (2 of 5 isolates) that had received gatifloxacin were resistant. In contrast, 100% of cases ( n = 4) that had received aminoglycosides were susceptible. Few culture‐confirmed cases occurred in patients who received intracameral antibiotic ( n = 4). Conclusions In cases where fluoroquinolones were administered as antibiotic prophylaxis, isolates demonstrated a degree of bacterial resistance. The majority of endophthalmitis cases isolated occured following topical antibiotic prophylaxis only and were attributed to Gram‐positive organisms, while few occurred in association with intracameral antibiotic.