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A retrospective review of endophthalmitis due to coagulase-negative staphylococci
Abstract:
We retrospectively reviewed 28 cases of postoperative endophthalmitis due to coagulase-negative staphylococci. There was an average delay between surgery and the acute presentation of 7 X 2 days (SD 3 X 3). All patients were treated with intraocular antibiotics (IOAB) or therapeutic vitrectomy with IOAB. In six of the 28 cases the organisms were resistant to gentamicin as measured by the Kirby-Bauer technique; none was resistant to cephalosporins. Isolates that had been stored by lyophilisation were reconstituted and tested by serial dilution; none was resistant to gentamicin, though two were borderline. The final visual acuity was 6/18 or better in 72% of the eyes.
Insights
Postoperative endophthalmitis caused by coagulase-negative staphylococci showed resistance to gentamicin in some cases. However, cephalosporins remained effective, and most patients achieved good visual acuity after treatment with intraocular antibiotics.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Postoperative endophthalmitis is a serious complication following ocular surgery.
- Coagulase-negative staphylococci are common causative agents of endophthalmitis.
- Antibiotic resistance is a growing concern in managing ocular infections.
Purpose of the Study:
- To evaluate the clinical outcomes and antibiotic susceptibility of coagulase-negative staphylococci in postoperative endophthalmitis.
- To assess the effectiveness of intraocular antibiotics (IOAB) and therapeutic vitrectomy.
- To determine the resistance patterns of causative organisms to commonly used antibiotics.
Main Methods:
- Retrospective review of 28 cases of postoperative endophthalmitis.
- Analysis of the delay between surgery and presentation.
- Treatment with intraocular antibiotics (IOAB) or therapeutic vitrectomy with IOAB.
- Antibiotic susceptibility testing using Kirby-Bauer and serial dilution methods.
Main Results:
- An average delay of 7 days between surgery and presentation was observed.
- Six out of 28 isolates showed resistance to gentamicin.
- No resistance to cephalosporins was detected.
- 72% of patients achieved a final visual acuity of 6/18 or better.
Conclusions:
- Coagulase-negative staphylococci remain a significant cause of postoperative endophthalmitis.
- Gentamicin resistance is a concern, while cephalosporins appear to be consistently effective.
- Prompt treatment with IOAB or vitrectomy can lead to favorable visual outcomes.