Stenotrophomonas maltophilia endogenous endophthalmitis: Clinical presentation, antibiotic susceptibility, and outcomes

Jay Chhablani, Aditya Sudhalkar, Animesh Jindal, Taraprasad Das, Swapna R. Motukupally, Savitri Sharma, Avinash Pathengay, Harry W Flynn

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: To describe clinical presentation, antibiotic susceptibility, and outcomes in patients with Stenotrophomonas maltophilia endogenous endophthalmitis. Design: Retrospective case series. Participants: Four eyes of four patients with S. maltophilia endogenous endophthalmitis. Methods: Retrospective chart review of culture-positive S. maltophilia endogenous endophthalmitis treated at L V Prasad Eye Institute, Hyderabad, India, between January 2007 and December 2012, was done. Collected information included demographic, clinical, and microbiology data. Results: These four patients with S. maltophilia endogenous endophthalmitis cases accounted for 0.47% (4/836) of total bacterial endophthalmitis cases treated in this period. All patients were from a rural setting and younger than 40 years. Two of the four patients had a history of immune compromise or hospitalization. The visual acuity at presentation was less than 20/320 in all patients. Common presenting features were severe anterior and posterior segment inflammation and hypopyon. All patients underwent vitrectomy with injection of intravitreal antibiotics and dexamethasone. Direct microscopy of the vitreous sample was positive in all cases. All isolates were sensitive to fluoroquinolones and chloramphenicol; sensitivity to aminoglycosides and third-generation cephalosporins was highly variable. The final visual acuity was 20/80 or more in three patients. The time to presentation did not seem to influence the visual or anatomical outcome. Conclusion: S. maltophilia is a rare cause of endogenous endophthalmitis and usually occurs in young and apparently healthy individuals. Clinical presentation is moderate to severe, and recovery is variable. Fourth-generation fluoroquinolones and chloramphenicol were the most sensitive antibiotics against S. maltophilia in this series of patients.

Original languageEnglish
Pages (from-to)1523-1526
Number of pages4
JournalClinical Ophthalmology
Volume8
DOIs
StatePublished - Aug 18 2014

Fingerprint

Stenotrophomonas maltophilia
Endophthalmitis
Anti-Bacterial Agents
Fluoroquinolones
Chloramphenicol
Visual Acuity
Intravitreal Injections
Vitrectomy
Aminoglycosides
Cephalosporins
Microbiology
Dexamethasone
India
Microscopy
Hospitalization
Demography
Inflammation

Keywords

  • Endogenous endophthalmitis
  • Pseudomonas maltophilia
  • Stenotrophomonas maltophilia
  • Xanthomonas maltophilia

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Stenotrophomonas maltophilia endogenous endophthalmitis : Clinical presentation, antibiotic susceptibility, and outcomes. / Chhablani, Jay; Sudhalkar, Aditya; Jindal, Animesh; Das, Taraprasad; Motukupally, Swapna R.; Sharma, Savitri; Pathengay, Avinash; Flynn, Harry W.

In: Clinical Ophthalmology, Vol. 8, 18.08.2014, p. 1523-1526.

Research output: Contribution to journalArticle

Chhablani, Jay ; Sudhalkar, Aditya ; Jindal, Animesh ; Das, Taraprasad ; Motukupally, Swapna R. ; Sharma, Savitri ; Pathengay, Avinash ; Flynn, Harry W. / Stenotrophomonas maltophilia endogenous endophthalmitis : Clinical presentation, antibiotic susceptibility, and outcomes. In: Clinical Ophthalmology. 2014 ; Vol. 8. pp. 1523-1526.
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abstract = "Objective: To describe clinical presentation, antibiotic susceptibility, and outcomes in patients with Stenotrophomonas maltophilia endogenous endophthalmitis. Design: Retrospective case series. Participants: Four eyes of four patients with S. maltophilia endogenous endophthalmitis. Methods: Retrospective chart review of culture-positive S. maltophilia endogenous endophthalmitis treated at L V Prasad Eye Institute, Hyderabad, India, between January 2007 and December 2012, was done. Collected information included demographic, clinical, and microbiology data. Results: These four patients with S. maltophilia endogenous endophthalmitis cases accounted for 0.47{\%} (4/836) of total bacterial endophthalmitis cases treated in this period. All patients were from a rural setting and younger than 40 years. Two of the four patients had a history of immune compromise or hospitalization. The visual acuity at presentation was less than 20/320 in all patients. Common presenting features were severe anterior and posterior segment inflammation and hypopyon. All patients underwent vitrectomy with injection of intravitreal antibiotics and dexamethasone. Direct microscopy of the vitreous sample was positive in all cases. All isolates were sensitive to fluoroquinolones and chloramphenicol; sensitivity to aminoglycosides and third-generation cephalosporins was highly variable. The final visual acuity was 20/80 or more in three patients. The time to presentation did not seem to influence the visual or anatomical outcome. Conclusion: S. maltophilia is a rare cause of endogenous endophthalmitis and usually occurs in young and apparently healthy individuals. Clinical presentation is moderate to severe, and recovery is variable. Fourth-generation fluoroquinolones and chloramphenicol were the most sensitive antibiotics against S. maltophilia in this series of patients.",
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AU - Chhablani, Jay

AU - Sudhalkar, Aditya

AU - Jindal, Animesh

AU - Das, Taraprasad

AU - Motukupally, Swapna R.

AU - Sharma, Savitri

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AU - Flynn, Harry W

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N2 - Objective: To describe clinical presentation, antibiotic susceptibility, and outcomes in patients with Stenotrophomonas maltophilia endogenous endophthalmitis. Design: Retrospective case series. Participants: Four eyes of four patients with S. maltophilia endogenous endophthalmitis. Methods: Retrospective chart review of culture-positive S. maltophilia endogenous endophthalmitis treated at L V Prasad Eye Institute, Hyderabad, India, between January 2007 and December 2012, was done. Collected information included demographic, clinical, and microbiology data. Results: These four patients with S. maltophilia endogenous endophthalmitis cases accounted for 0.47% (4/836) of total bacterial endophthalmitis cases treated in this period. All patients were from a rural setting and younger than 40 years. Two of the four patients had a history of immune compromise or hospitalization. The visual acuity at presentation was less than 20/320 in all patients. Common presenting features were severe anterior and posterior segment inflammation and hypopyon. All patients underwent vitrectomy with injection of intravitreal antibiotics and dexamethasone. Direct microscopy of the vitreous sample was positive in all cases. All isolates were sensitive to fluoroquinolones and chloramphenicol; sensitivity to aminoglycosides and third-generation cephalosporins was highly variable. The final visual acuity was 20/80 or more in three patients. The time to presentation did not seem to influence the visual or anatomical outcome. Conclusion: S. maltophilia is a rare cause of endogenous endophthalmitis and usually occurs in young and apparently healthy individuals. Clinical presentation is moderate to severe, and recovery is variable. Fourth-generation fluoroquinolones and chloramphenicol were the most sensitive antibiotics against S. maltophilia in this series of patients.

AB - Objective: To describe clinical presentation, antibiotic susceptibility, and outcomes in patients with Stenotrophomonas maltophilia endogenous endophthalmitis. Design: Retrospective case series. Participants: Four eyes of four patients with S. maltophilia endogenous endophthalmitis. Methods: Retrospective chart review of culture-positive S. maltophilia endogenous endophthalmitis treated at L V Prasad Eye Institute, Hyderabad, India, between January 2007 and December 2012, was done. Collected information included demographic, clinical, and microbiology data. Results: These four patients with S. maltophilia endogenous endophthalmitis cases accounted for 0.47% (4/836) of total bacterial endophthalmitis cases treated in this period. All patients were from a rural setting and younger than 40 years. Two of the four patients had a history of immune compromise or hospitalization. The visual acuity at presentation was less than 20/320 in all patients. Common presenting features were severe anterior and posterior segment inflammation and hypopyon. All patients underwent vitrectomy with injection of intravitreal antibiotics and dexamethasone. Direct microscopy of the vitreous sample was positive in all cases. All isolates were sensitive to fluoroquinolones and chloramphenicol; sensitivity to aminoglycosides and third-generation cephalosporins was highly variable. The final visual acuity was 20/80 or more in three patients. The time to presentation did not seem to influence the visual or anatomical outcome. Conclusion: S. maltophilia is a rare cause of endogenous endophthalmitis and usually occurs in young and apparently healthy individuals. Clinical presentation is moderate to severe, and recovery is variable. Fourth-generation fluoroquinolones and chloramphenicol were the most sensitive antibiotics against S. maltophilia in this series of patients.

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KW - Pseudomonas maltophilia

KW - Stenotrophomonas maltophilia

KW - Xanthomonas maltophilia

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