TY - JOUR
T1 - Endophthalmitis caused by pseudomonas aeruginosa
T2 - Clinical features, antibiotic susceptibilities, and treatment outcomes
AU - Sridhar, Jayanth
AU - Kuriyan, Ajay E.
AU - Flynn, Harry W.
AU - Miller, Darlene
N1 - Publisher Copyright:
Copyright © by Ophthaimac Communications Society, Inc.unauthorized Reproduction Of This Article Is Prohibited.
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 - Pseudomonas
KW - bacterial eye infections
KW - endophthalmitis
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 -