TY - JOUR
T1 - Stenotrophomonas maltophilia endophthalmitis following cataract surgery
T2 - Clinical and microbiological results
AU - Chang, Jonathan S.
AU - Flynn, Harry W.
AU - Miller, Darlene
AU - Smiddy, William E.
PY - 2013/4/18
Y1 - 2013/4/18
N2 - Background: Stenotrophomonas maltophilia is a Gram-negative organism known to cause opportunistic infections. It is a rare source of endophthalmitis, often in the setting of trauma, but has been reported following cataract extraction. The purpose of this study was to evaluate antimicrobial sensitivities, clinical characteristics, and treatment outcomes in patients with endophthalmitis caused by S. maltophilia following cataract extraction. Methods: A retrospective case review of records from January 1, 1990 to June 30, 2010 was performed at the Bascom Palmer Eye Institute. Results: Eight cases of S. maltophilia endophthalmitis were identified following cataract surgery. Initial visual acuity ranged from 20/200 to light perception. Time to diagnosis with cultures was 2-118 days. Patients received either intravitreal tap and inject (n = 5) or pars plana vitrectomy with intravitreal antibiotic injections (n = 3). All patients had vitreous or anterior chamber cultures positive for S. maltophilia. Seven of seven isolates tested were found to be sensitive to ceftazidime. Seven of eight isolates were sensitive to polymyxin B, six of eight isolates were sensitive to amikacin, and five of the seven isolates tested were sensitive to ciprofloxacin. Two of four tested isolates were sensitive to trimethoprim-sulbactam. All eight isolates were resistant to gentamicin and seven of the seven tested isolates were resistant to imipenem. All patients received intravitreal ceftazidime as part of the initial treatment regimen. Final visual acuity ranged from 20/25 to 4/200. Conclusion: S. maltophilia endophthalmitis is a rare source of endophthalmitis following cataract surgery. A case series of eight independent patients is reported, along with antibiotic resistance profiles and clinical outcomes. Isolates showed sensitivity to ceftazidime, amikacin, and polymyxin, with variable sensitivity to other antibiotics, therefore differing from previous reports.
AB - Background: Stenotrophomonas maltophilia is a Gram-negative organism known to cause opportunistic infections. It is a rare source of endophthalmitis, often in the setting of trauma, but has been reported following cataract extraction. The purpose of this study was to evaluate antimicrobial sensitivities, clinical characteristics, and treatment outcomes in patients with endophthalmitis caused by S. maltophilia following cataract extraction. Methods: A retrospective case review of records from January 1, 1990 to June 30, 2010 was performed at the Bascom Palmer Eye Institute. Results: Eight cases of S. maltophilia endophthalmitis were identified following cataract surgery. Initial visual acuity ranged from 20/200 to light perception. Time to diagnosis with cultures was 2-118 days. Patients received either intravitreal tap and inject (n = 5) or pars plana vitrectomy with intravitreal antibiotic injections (n = 3). All patients had vitreous or anterior chamber cultures positive for S. maltophilia. Seven of seven isolates tested were found to be sensitive to ceftazidime. Seven of eight isolates were sensitive to polymyxin B, six of eight isolates were sensitive to amikacin, and five of the seven isolates tested were sensitive to ciprofloxacin. Two of four tested isolates were sensitive to trimethoprim-sulbactam. All eight isolates were resistant to gentamicin and seven of the seven tested isolates were resistant to imipenem. All patients received intravitreal ceftazidime as part of the initial treatment regimen. Final visual acuity ranged from 20/25 to 4/200. Conclusion: S. maltophilia endophthalmitis is a rare source of endophthalmitis following cataract surgery. A case series of eight independent patients is reported, along with antibiotic resistance profiles and clinical outcomes. Isolates showed sensitivity to ceftazidime, amikacin, and polymyxin, with variable sensitivity to other antibiotics, therefore differing from previous reports.
KW - Cataract
KW - Endophthalmitis
KW - Stenotrophomonas maltophilia
UR - http://www.scopus.com/inward/record.url?scp=84876440125&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84876440125&partnerID=8YFLogxK
U2 - 10.2147/OPTH.S39608
DO - 10.2147/OPTH.S39608
M3 - Article
C2 - 23620659
AN - SCOPUS:84876440125
VL - 7
SP - 771
EP - 777
JO - Clinical Ophthalmology
JF - Clinical Ophthalmology
SN - 1177-5467
ER -