Endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility: literature review and options for treatment

Nidhi Relhan, Thomas A Albini, Avinash Pathengay, Ajay Kuriyan, Darlene Miller, Harry W Flynn

Research output: Contribution to journalReview article

19 Citations (Scopus)

Abstract

BACKGROUND: Endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility and/or resistance is an important clinical issue worldwide.

PURPOSE: To review the published literature on endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility and/or vancomycin resistance.

METHODS: The data were analysed from a PubMed search of endophthalmitis cases caused by Gram-positive organisms with reported reduced vancomycin susceptibility and/or vancomycin resistance from 1990 to 2015.

RESULTS: From 18 publications identified, a total of 27 endophthalmitis cases caused by Gram-positive organisms with reduced vancomycin susceptibility and/or vancomycin resistance were identified. The aetiologies of endophthalmitis were exogenous in 19/27 cases (11 post-cataract surgery, 2 post-penetrating keratoplasty, 1 post-glaucoma surgery, 4 post-open globe injury, 1 post-intravitreal injection of ranibizumab), and endogenous in 4/24 cases; no details were available about the four remaining patients. The causative organisms included Enterococcus species (7/27), coagulase-negative staphylococci (4/27), Staphylococcus aureus (4/27), Bacillus species (4/27), Streptococcus species (3/27), Leuconostoc species (3/27), Staphylococcus hominis (1/27), and unidentified Gram-positive cocci (1/27). Visual acuity of 20/400 or better at the final follow-up was recorded in 10/26 patients (38.5%; data were not available for one patient). Treatment options include fluoroquinolones, penicillin, cephalosporins, tetracyclines, and oxazolidinones.

CONCLUSIONS: In the current study, visual acuity outcomes were generally poor. Enterococcus and Staphylococcus species were the most common organisms reported and postoperative endophthalmitis after cataract surgery was the most common clinical setting.

Original languageEnglish (US)
Pages (from-to)446-452
Number of pages7
JournalThe British journal of ophthalmology
Volume100
Issue number4
DOIs
StatePublished - Apr 1 2016

Fingerprint

Endophthalmitis
Vancomycin
Vancomycin Resistance
Enterococcus
Staphylococcus
Cataract
Visual Acuity
Staphylococcus hominis
Therapeutics
Oxazolidinones
Leuconostoc
Gram-Positive Cocci
Tetracyclines
Penetrating Keratoplasty
Intravitreal Injections
Coagulase
Fluoroquinolones
Cephalosporins
Streptococcus
PubMed

Keywords

  • Eye (Globe)
  • Infection
  • Microbiology
  • Retina
  • Vitreous

ASJC Scopus subject areas

  • Medicine(all)
  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility : literature review and options for treatment. / Relhan, Nidhi; Albini, Thomas A; Pathengay, Avinash; Kuriyan, Ajay; Miller, Darlene; Flynn, Harry W.

In: The British journal of ophthalmology, Vol. 100, No. 4, 01.04.2016, p. 446-452.

Research output: Contribution to journalReview article

@article{a5ff03c7464b47748af190889e7829ff,
title = "Endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility: literature review and options for treatment",
abstract = "BACKGROUND: Endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility and/or resistance is an important clinical issue worldwide.PURPOSE: To review the published literature on endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility and/or vancomycin resistance.METHODS: The data were analysed from a PubMed search of endophthalmitis cases caused by Gram-positive organisms with reported reduced vancomycin susceptibility and/or vancomycin resistance from 1990 to 2015.RESULTS: From 18 publications identified, a total of 27 endophthalmitis cases caused by Gram-positive organisms with reduced vancomycin susceptibility and/or vancomycin resistance were identified. The aetiologies of endophthalmitis were exogenous in 19/27 cases (11 post-cataract surgery, 2 post-penetrating keratoplasty, 1 post-glaucoma surgery, 4 post-open globe injury, 1 post-intravitreal injection of ranibizumab), and endogenous in 4/24 cases; no details were available about the four remaining patients. The causative organisms included Enterococcus species (7/27), coagulase-negative staphylococci (4/27), Staphylococcus aureus (4/27), Bacillus species (4/27), Streptococcus species (3/27), Leuconostoc species (3/27), Staphylococcus hominis (1/27), and unidentified Gram-positive cocci (1/27). Visual acuity of 20/400 or better at the final follow-up was recorded in 10/26 patients (38.5{\%}; data were not available for one patient). Treatment options include fluoroquinolones, penicillin, cephalosporins, tetracyclines, and oxazolidinones.CONCLUSIONS: In the current study, visual acuity outcomes were generally poor. Enterococcus and Staphylococcus species were the most common organisms reported and postoperative endophthalmitis after cataract surgery was the most common clinical setting.",
keywords = "Eye (Globe), Infection, Microbiology, Retina, Vitreous",
author = "Nidhi Relhan and Albini, {Thomas A} and Avinash Pathengay and Ajay Kuriyan and Darlene Miller and Flynn, {Harry W}",
year = "2016",
month = "4",
day = "1",
doi = "10.1136/bjophthalmol-2015-307722",
language = "English (US)",
volume = "100",
pages = "446--452",
journal = "British Journal of Ophthalmology",
issn = "0007-1161",
publisher = "BMJ Publishing Group",
number = "4",

}

TY - JOUR

T1 - Endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility

T2 - literature review and options for treatment

AU - Relhan, Nidhi

AU - Albini, Thomas A

AU - Pathengay, Avinash

AU - Kuriyan, Ajay

AU - Miller, Darlene

AU - Flynn, Harry W

PY - 2016/4/1

Y1 - 2016/4/1

N2 - BACKGROUND: Endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility and/or resistance is an important clinical issue worldwide.PURPOSE: To review the published literature on endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility and/or vancomycin resistance.METHODS: The data were analysed from a PubMed search of endophthalmitis cases caused by Gram-positive organisms with reported reduced vancomycin susceptibility and/or vancomycin resistance from 1990 to 2015.RESULTS: From 18 publications identified, a total of 27 endophthalmitis cases caused by Gram-positive organisms with reduced vancomycin susceptibility and/or vancomycin resistance were identified. The aetiologies of endophthalmitis were exogenous in 19/27 cases (11 post-cataract surgery, 2 post-penetrating keratoplasty, 1 post-glaucoma surgery, 4 post-open globe injury, 1 post-intravitreal injection of ranibizumab), and endogenous in 4/24 cases; no details were available about the four remaining patients. The causative organisms included Enterococcus species (7/27), coagulase-negative staphylococci (4/27), Staphylococcus aureus (4/27), Bacillus species (4/27), Streptococcus species (3/27), Leuconostoc species (3/27), Staphylococcus hominis (1/27), and unidentified Gram-positive cocci (1/27). Visual acuity of 20/400 or better at the final follow-up was recorded in 10/26 patients (38.5%; data were not available for one patient). Treatment options include fluoroquinolones, penicillin, cephalosporins, tetracyclines, and oxazolidinones.CONCLUSIONS: In the current study, visual acuity outcomes were generally poor. Enterococcus and Staphylococcus species were the most common organisms reported and postoperative endophthalmitis after cataract surgery was the most common clinical setting.

AB - BACKGROUND: Endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility and/or resistance is an important clinical issue worldwide.PURPOSE: To review the published literature on endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility and/or vancomycin resistance.METHODS: The data were analysed from a PubMed search of endophthalmitis cases caused by Gram-positive organisms with reported reduced vancomycin susceptibility and/or vancomycin resistance from 1990 to 2015.RESULTS: From 18 publications identified, a total of 27 endophthalmitis cases caused by Gram-positive organisms with reduced vancomycin susceptibility and/or vancomycin resistance were identified. The aetiologies of endophthalmitis were exogenous in 19/27 cases (11 post-cataract surgery, 2 post-penetrating keratoplasty, 1 post-glaucoma surgery, 4 post-open globe injury, 1 post-intravitreal injection of ranibizumab), and endogenous in 4/24 cases; no details were available about the four remaining patients. The causative organisms included Enterococcus species (7/27), coagulase-negative staphylococci (4/27), Staphylococcus aureus (4/27), Bacillus species (4/27), Streptococcus species (3/27), Leuconostoc species (3/27), Staphylococcus hominis (1/27), and unidentified Gram-positive cocci (1/27). Visual acuity of 20/400 or better at the final follow-up was recorded in 10/26 patients (38.5%; data were not available for one patient). Treatment options include fluoroquinolones, penicillin, cephalosporins, tetracyclines, and oxazolidinones.CONCLUSIONS: In the current study, visual acuity outcomes were generally poor. Enterococcus and Staphylococcus species were the most common organisms reported and postoperative endophthalmitis after cataract surgery was the most common clinical setting.

KW - Eye (Globe)

KW - Infection

KW - Microbiology

KW - Retina

KW - Vitreous

UR - http://www.scopus.com/inward/record.url?scp=84982811764&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84982811764&partnerID=8YFLogxK

U2 - 10.1136/bjophthalmol-2015-307722

DO - 10.1136/bjophthalmol-2015-307722

M3 - Review article

C2 - 26701686

AN - SCOPUS:84982811764

VL - 100

SP - 446

EP - 452

JO - British Journal of Ophthalmology

JF - British Journal of Ophthalmology

SN - 0007-1161

IS - 4

ER -