Clinical features and treatment outcomes of acute-onset endophthalmitis caused by Staphylococcus lugdunensis: a case series

PURPOSE: To report a series of patients with acute-onset endophthalmitis caused by culture-proven Staphylococcus lugdunensis and to provide an update on the microbiologic susceptibility and clinical outcomes resulting from this organism. OBSERVATIONS: This study included 6 eyes of 6 patients. The etiologies included cataract surgery (4), intravitreal injection (1), and posterior segment surgery (1). All isolates (100%) of S. lugdunensis demonstrated sensitivity to vancomycin with minimal inhibitory concentration (MIC) values ranging from ≤ 0.5 to 1 mcg/mL and to moxifloxacin with MIC values ranging from ≤ 0.25 to 1 mcg/mL. One of 6 isolates demonstrated intermediate resistance to gentamicin with a MIC value of 8 mcg/mL. Four of 6 patients underwent pars plana vitrectomy following initial treatment with intravitreal antibiotics, and 1 eye underwent vitrectomy as initial management. Best-corrected visual acuity at last follow-up examination was≥ 20/150 in 5/6 (83.3%) of cases and ≥ 20/40 in 3/6 (50%) of cases. CONCLUSION AND IMPORTANCE: In this study, patients with acute-onset endophthalmitis caused by S. lugdunensis had relatively good outcomes, similar to a previous case series. Vancomycin continues to have consistent coverage against S. lugdunensis and remains an empiric therapeutic option for acute-onset endophthalmitis.