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Intravitreal Injection and Quantitation of Infection Parameters in a Mouse Model of Bacterial Endophthalmitis
Published on: February 6, 2021
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Endogenous endophthalmitis due to clinically vancomycin-resistant Staphylococcus aureus.
Vaidehi S Dedania1, Benjamin P Hale, Pawan Bhatnagar
1*Department of Ophthalmology, Albany Medical Center, Lions Eye Institute, Albany, New York; and †Retina Consultants PLLC, Department of Ophthalmology, Division of Vitreoretinal Surgery, Albany Medical College, Slingerlands, New York.
Retinal Cases & Brief Reports
|November 11, 2014
Summary
This case report highlights a patient with methicillin-resistant Staphylococcus aureus endophthalmitis that appeared resistant to vancomycin. Alternative treatments, including daptomycin, led to improved vision and infection control.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Medical Microbiology
Background:
- Endogenous endophthalmitis is a severe intraocular infection often associated with bacteremia.
- Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen, and its resistance patterns can complicate treatment.
- Vancomycin is a primary treatment for MRSA infections, but resistance can emerge.
Observation:
- A 48-year-old woman with MRSA bacteremia developed bilateral endophthalmitis with decreased visual acuity.
- Initial treatment with intravenous and intravitreal vancomycin, along with intravitreal ceftazidime, failed to improve the condition.
- The patient's visual acuity deteriorated despite standard therapy.
Findings:
- An alternative treatment regimen including intravenous daptomycin and intravitreal clindamycin and amikacin was initiated.
- This new regimen led to clinical improvement, including reduced anterior chamber inflammation and vitritis.
- Visual acuity improved to 20/40 in one eye, with light perception maintained in the other.
Implications:
- This case suggests that clinical vancomycin resistance should be considered in MRSA endophthalmitis, especially with borderline sensitivities.
- Alternative antibiotic strategies may be necessary for MRSA endophthalmitis unresponsive to vancomycin.
- Further investigation into treatment protocols for resistant MRSA endophthalmitis is warranted.
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