Endophthalmitis caused by pseudomonas aeruginosa: Clinical features, antibiotic susceptibilities, and treatment outcomes

Jayanth Sridhar, Ajay Kuriyan, Harry W Flynn, Darlene Miller

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Purpose: To report the clinical features, antibiotic susceptibilities, and visual outcomes associated with endophthalmitis caused by Pseudomonas aeruginosa. Methods: A consecutive case series. Microbiology database records were retrospectively reviewed for all patients with endophthalmitis caused by P. aeruginosa from January 1, 2002, to December 31, 2012, at a large university referral center. The corresponding clinical records were then reviewed to evaluate the endophthalmitis clinical features and treatment outcomes. Results: In the 12 patients identified, clinical settings included postcataract surgery (n 4), postpenetrating keratoplasty (n 3), endogenous source (n 2), post-pars plana vitrectomy (n 1), trabeculectomy bleb-associated setting (n 1), and glaucoma drainage implant-associated setting (n 1). All patients presented with hypopyon. Presenting visual acuity was hand motions or worse in all cases. All isolates were susceptible to ceftazidime and levofloxacin. When comparing isolates in this study with isolates from a previous study (1987 to 2001), the minimal inhibitory concentration required to inhibit 90% of isolates (MIC 90, in micrograms per milliliter) remained the same for ceftazidime (8), ciprofloxacin (0.5), imipenem (4), tobramycin (0.5), and amikacin (4). Initial treatment strategies were vitreous tap and injection (n 9) and pars plana vitrectomy with intravitreal antibiotics (n 3). Final visual acuity was light perception or worse in 11 of the 12 patients (92%). Five patients underwent enucleation (42%). Conclusion: All isolates were susceptible to ceftazidime and levofloxacin, and all MIC 90s for isolates in the current period compared with isolates from 1987 to 2001 remained identical. Despite early and appropriate treatment, outcomes were generally poor with a high rate of enucleation.

Original languageEnglish (US)
Pages (from-to)1101-1106
Number of pages6
JournalRetina
Volume35
Issue number6
DOIs
StatePublished - Jun 6 2015

Fingerprint

Endophthalmitis
Pseudomonas aeruginosa
Ceftazidime
Anti-Bacterial Agents
Levofloxacin
Temazepam
Vitrectomy
Visual Acuity
Glaucoma Drainage Implants
Tobramycin
Trabeculectomy
Corneal Transplantation
Amikacin
Imipenem
Blister
Ciprofloxacin
Microbiology
Referral and Consultation
Hand
Databases

Keywords

  • bacterial eye infections
  • endophthalmitis
  • Pseudomonas

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Endophthalmitis caused by pseudomonas aeruginosa : Clinical features, antibiotic susceptibilities, and treatment outcomes. / Sridhar, Jayanth; Kuriyan, Ajay; Flynn, Harry W; Miller, Darlene.

In: Retina, Vol. 35, No. 6, 06.06.2015, p. 1101-1106.

Research output: Contribution to journalArticle

@article{0108df82a777476693d9c62bb290edb9,
title = "Endophthalmitis caused by pseudomonas aeruginosa: Clinical features, antibiotic susceptibilities, and treatment outcomes",
abstract = "Purpose: To report the clinical features, antibiotic susceptibilities, and visual outcomes associated with endophthalmitis caused by Pseudomonas aeruginosa. Methods: A consecutive case series. Microbiology database records were retrospectively reviewed for all patients with endophthalmitis caused by P. aeruginosa from January 1, 2002, to December 31, 2012, at a large university referral center. The corresponding clinical records were then reviewed to evaluate the endophthalmitis clinical features and treatment outcomes. Results: In the 12 patients identified, clinical settings included postcataract surgery (n 4), postpenetrating keratoplasty (n 3), endogenous source (n 2), post-pars plana vitrectomy (n 1), trabeculectomy bleb-associated setting (n 1), and glaucoma drainage implant-associated setting (n 1). All patients presented with hypopyon. Presenting visual acuity was hand motions or worse in all cases. All isolates were susceptible to ceftazidime and levofloxacin. When comparing isolates in this study with isolates from a previous study (1987 to 2001), the minimal inhibitory concentration required to inhibit 90{\%} of isolates (MIC 90, in micrograms per milliliter) remained the same for ceftazidime (8), ciprofloxacin (0.5), imipenem (4), tobramycin (0.5), and amikacin (4). Initial treatment strategies were vitreous tap and injection (n 9) and pars plana vitrectomy with intravitreal antibiotics (n 3). Final visual acuity was light perception or worse in 11 of the 12 patients (92{\%}). Five patients underwent enucleation (42{\%}). Conclusion: All isolates were susceptible to ceftazidime and levofloxacin, and all MIC 90s for isolates in the current period compared with isolates from 1987 to 2001 remained identical. Despite early and appropriate treatment, outcomes were generally poor with a high rate of enucleation.",
keywords = "bacterial eye infections, endophthalmitis, Pseudomonas",
author = "Jayanth Sridhar and Ajay Kuriyan and Flynn, {Harry W} and Darlene Miller",
year = "2015",
month = "6",
day = "6",
doi = "10.1097/IAE.0000000000000469",
language = "English (US)",
volume = "35",
pages = "1101--1106",
journal = "Retina",
issn = "0275-004X",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Endophthalmitis caused by pseudomonas aeruginosa

T2 - Clinical features, antibiotic susceptibilities, and treatment outcomes

AU - Sridhar, Jayanth

AU - Kuriyan, Ajay

AU - Flynn, Harry W

AU - Miller, Darlene

PY - 2015/6/6

Y1 - 2015/6/6

N2 - Purpose: To report the clinical features, antibiotic susceptibilities, and visual outcomes associated with endophthalmitis caused by Pseudomonas aeruginosa. Methods: A consecutive case series. Microbiology database records were retrospectively reviewed for all patients with endophthalmitis caused by P. aeruginosa from January 1, 2002, to December 31, 2012, at a large university referral center. The corresponding clinical records were then reviewed to evaluate the endophthalmitis clinical features and treatment outcomes. Results: In the 12 patients identified, clinical settings included postcataract surgery (n 4), postpenetrating keratoplasty (n 3), endogenous source (n 2), post-pars plana vitrectomy (n 1), trabeculectomy bleb-associated setting (n 1), and glaucoma drainage implant-associated setting (n 1). All patients presented with hypopyon. Presenting visual acuity was hand motions or worse in all cases. All isolates were susceptible to ceftazidime and levofloxacin. When comparing isolates in this study with isolates from a previous study (1987 to 2001), the minimal inhibitory concentration required to inhibit 90% of isolates (MIC 90, in micrograms per milliliter) remained the same for ceftazidime (8), ciprofloxacin (0.5), imipenem (4), tobramycin (0.5), and amikacin (4). Initial treatment strategies were vitreous tap and injection (n 9) and pars plana vitrectomy with intravitreal antibiotics (n 3). Final visual acuity was light perception or worse in 11 of the 12 patients (92%). Five patients underwent enucleation (42%). Conclusion: All isolates were susceptible to ceftazidime and levofloxacin, and all MIC 90s for isolates in the current period compared with isolates from 1987 to 2001 remained identical. Despite early and appropriate treatment, outcomes were generally poor with a high rate of enucleation.

AB - Purpose: To report the clinical features, antibiotic susceptibilities, and visual outcomes associated with endophthalmitis caused by Pseudomonas aeruginosa. Methods: A consecutive case series. Microbiology database records were retrospectively reviewed for all patients with endophthalmitis caused by P. aeruginosa from January 1, 2002, to December 31, 2012, at a large university referral center. The corresponding clinical records were then reviewed to evaluate the endophthalmitis clinical features and treatment outcomes. Results: In the 12 patients identified, clinical settings included postcataract surgery (n 4), postpenetrating keratoplasty (n 3), endogenous source (n 2), post-pars plana vitrectomy (n 1), trabeculectomy bleb-associated setting (n 1), and glaucoma drainage implant-associated setting (n 1). All patients presented with hypopyon. Presenting visual acuity was hand motions or worse in all cases. All isolates were susceptible to ceftazidime and levofloxacin. When comparing isolates in this study with isolates from a previous study (1987 to 2001), the minimal inhibitory concentration required to inhibit 90% of isolates (MIC 90, in micrograms per milliliter) remained the same for ceftazidime (8), ciprofloxacin (0.5), imipenem (4), tobramycin (0.5), and amikacin (4). Initial treatment strategies were vitreous tap and injection (n 9) and pars plana vitrectomy with intravitreal antibiotics (n 3). Final visual acuity was light perception or worse in 11 of the 12 patients (92%). Five patients underwent enucleation (42%). Conclusion: All isolates were susceptible to ceftazidime and levofloxacin, and all MIC 90s for isolates in the current period compared with isolates from 1987 to 2001 remained identical. Despite early and appropriate treatment, outcomes were generally poor with a high rate of enucleation.

KW - bacterial eye infections

KW - endophthalmitis

KW - Pseudomonas

UR - http://www.scopus.com/inward/record.url?scp=84930474084&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930474084&partnerID=8YFLogxK

U2 - 10.1097/IAE.0000000000000469

DO - 10.1097/IAE.0000000000000469

M3 - Article

C2 - 25658178

AN - SCOPUS:84930474084

VL - 35

SP - 1101

EP - 1106

JO - Retina

JF - Retina

SN - 0275-004X

IS - 6

ER -