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Endophthalmitis caused by gram-negative organisms
W D Irvine1, H W Flynn, D Miller
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami (Fla) School of Medicine 33101.
Abstract:
The medical records of 52 patients (53 eyes) with culture-proven gram-negative endophthalmitis between January 1982 and December 1990 were reviewed. Pseudomonas aeruginosa (23% [12/53]) and Haemophilus influenzae (19% [10/53]) were the most frequent isolates in this series. Overall, 26 (49%) of 53 treated patients achieved 20/400 or better visual acuity. Fifty-two (98%) of the original 53 gram-negative isolates were sensitive to the aminoglycoside antibiotics. To determine their sensitivity to recently developed antibiotics, 35 of the isolates were again grown on culture media and their sensitivities to ceftazidime, ciprofloxacin, and imipenem were obtained. Only ceftazidime demonstrated in vitro efficacy for all the organisms tested.
Insights
Gram-negative endophthalmitis treatment outcomes show limited visual acuity. However, gram-negative isolates remained sensitive to aminoglycoside antibiotics, with ceftazidime demonstrating broad in vitro efficacy.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Gram-negative endophthalmitis is a severe intraocular infection.
- Pseudomonas aeruginosa and Haemophilus influenzae were the most common pathogens identified.
Purpose of the Study:
- To review treatment outcomes for gram-negative endophthalmitis.
- To assess antibiotic sensitivity patterns of gram-negative isolates.
- To evaluate the in vitro efficacy of newer antibiotics against these pathogens.
Main Methods:
- Retrospective review of 52 patients (53 eyes) with culture-proven gram-negative endophthalmitis (1982-1990).
- Analysis of initial antibiotic sensitivities, particularly to aminoglycosides.
- In vitro susceptibility testing of 35 isolates against ceftazidime, ciprofloxacin, and imipenem.
Main Results:
- 49% of patients achieved a visual acuity of 20/400 or better.
- 98% of gram-negative isolates were sensitive to aminoglycoside antibiotics.
- Ceftazidime demonstrated in vitro efficacy against all tested organisms.
Conclusions:
- Gram-negative endophthalmitis treatment yielded suboptimal visual acuity in nearly half of cases.
- Aminoglycosides remain effective against most gram-negative endophthalmitis isolates.
- Ceftazidime shows promising in vitro activity and warrants consideration for treating gram-negative endophthalmitis.