Endophthalmitis Caused by Streptococcus:Clinical Outcomes and Antimicrobial Susceptibilities 2014-2019

To report the clinical settings, antibiotic susceptibilities, and outcomes of streptococcal endophthalmitis.

Retrospective case series evaluating culture-positive streptococcal endophthalmitis from January 1, 2014, to December 31, 2019.

Thirty-eight eyes met study criteria. The most common clinical setting was post-glaucoma surgery (33.3%, 12/36). The most frequent isolate was Streptococcus viridans (63.2%, 24/38). Isolates were susceptible to vancomycin (100%, 36/36), ceftriaxone (100%, 28/28), and levofloxacin (100%, 36/36). Final best-corrected visual acuity was 20/150 or better in 24.1% (7/29) but 20/200 or worse in 75.9% (22/29). Enucleation was performed in 11.1% (4/36). A subset (n = 11) of cases were evaluated for streptococcal-specific virulence factors: pneumolysin was present in 18.2% (2/11), autolysin in 45.5% (5/11), and hyaluronidase in 54.5% (6/11). Clinical setting, antibacterial susceptibilities, timing of pars plana vitrectomy, and virulence factor presence were not associated with better visual outcome or enucleation rate (P > .05).

Visual prognosis for streptococcal endophthalmitis is poor despite early and appropriate antibiotic treatment. [.