Pathogens and antibiotic sensitivities in endophthalmitis

Geraldine R. Slean, Neal H. Shorstein, Liyan Liu, John F. Paschal, Kevin Winthrop, Lisa J. Herrinton

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalClinical and Experimental Ophthalmology
DOIs
StateAccepted/In press - 2017

Fingerprint

Endophthalmitis
Antibiotic Prophylaxis
Anti-Bacterial Agents
Cataract
Ofloxacin
Coagulase
Fluoroquinolones
Aminoglycosides
Vancomycin
Staphylococcus
Outcome Assessment (Health Care)

Keywords

  • Antibiotic
  • Cataract surgery
  • Endophthalmitis
  • Sensitivity

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Slean, G. R., Shorstein, N. H., Liu, L., Paschal, J. F., Winthrop, K., & Herrinton, L. J. (Accepted/In press). Pathogens and antibiotic sensitivities in endophthalmitis. Clinical and Experimental Ophthalmology. https://doi.org/10.1111/ceo.12910

Pathogens and antibiotic sensitivities in endophthalmitis. / Slean, Geraldine R.; Shorstein, Neal H.; Liu, Liyan; Paschal, John F.; Winthrop, Kevin; Herrinton, Lisa J.

In: Clinical and Experimental Ophthalmology, 2017.

Research output: Contribution to journalArticle

Slean, Geraldine R. ; Shorstein, Neal H. ; Liu, Liyan ; Paschal, John F. ; Winthrop, Kevin ; Herrinton, Lisa J. / Pathogens and antibiotic sensitivities in endophthalmitis. In: Clinical and Experimental Ophthalmology. 2017.
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abstract = "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.",
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