TY - JOUR T1 - Endophthalmitis after penetrating keratoplasty: microbiologic spectrum and susceptibility of isolates JF - Am J Ophthalmol Y1 - 2004 A1 - Kunimoto,D. Y. A1 - Tasman,W. A1 - Rapuano,C. A1 - Recchia,F. A1 - Busbee,B. A1 - Pearlman,R. A1 - Belmont,J. A1 - Cohen,E. A1 - Vander,J. A1 - Laibson,P. A1 - Raber,I. KW - *Postoperative Complications KW - Bacteria / drug effects / *isolation & purification KW - Drug Resistance, Bacterial KW - Endophthalmitis / *microbiology KW - Humans KW - Keratoplasty, Penetrating / *adverse effects KW - Microbial Sensitivity Tests KW - Vitreous Body / microbiology AB - PURPOSE: To present the microbial spectrum and susceptibilities of isolates in endophthalmitis following penetrating keratoplasty. DESIGN: Interventional case series. METHODS: The 1,074 consecutive cases of endophthalmitis presenting to Wills Eye Hospital between 1989 and 2000 were reviewed. Fourteen patients with endophthalmitis after penetrating keratoplasty were identified, and vitreous biopsy isolates from these patients were examined. RESULTS: Eleven (78.6%) of 14 vitreous samples were culture-positive, and two others (14.3%) had organisms viewed on pathology specimen, for a total of 13 (92.9%) organism-proven cases of endophthalmitis. Isolates included 10 (76.9%) gram-positive cocci (six Streptococcus sp., three Staphylococcus sp., one identified on pathology specimen only) and three (23.1%) gram-negative organisms (Proteus mirabilis, Serratia marcescens, one identified on pathology specimen only). Susceptibilities to organism-appropriate antibiotic testing are reported, including cefazolin (six of eight, 75.0%), ciprofloxacin (four of seven, 57.1%), nafcillin (four of six, 66.7%), and vancomycin (seven of seven, 100.0%). CONCLUSION: This is the largest series on microbial susceptibilities in postpenetrating keratoplasty endophthalmitis. We report a high percentage of culture-positivity, and a high incidence of gram-positive species, and in particular Streptococcus species, with all tested gram-positive organisms susceptible to vancomycin. VL - 137 ER - internal-pdf://Kunimoto - Endophthalmitis-3182236416/Kunimoto - Endophthalmitis.pdf CP - 2 N1 - Kunimoto, Derek Y Tasman, William Rapuano, Christopher Recchia, Franco Busbee, Brandon Pearlman, Robert Belmont, Jonathan Cohen, Elisabeth Vander, James Laibson, Peter Raber, Irving Research Support, Non-U.S. Gov't United States American journal of ophthalmology ID - 848 ER -