Endophthalmitis after penetrating keratoplasty: microbiologic spectrum and susceptibility of isolates

TitleEndophthalmitis after penetrating keratoplasty: microbiologic spectrum and susceptibility of isolates
Publication TypeJournal Article
Year of Publication2004
AuthorsKunimoto DY, Tasman W, Rapuano C, Recchia F, Busbee B, Pearlman R, Belmont J, Cohen E, Vander J, Laibson P, Raber I
JournalAm J Ophthalmol
Pagination343 - 5
Date PublishedFeb
ISSN0002-9394 (Print) 0002-9394 (Linking)
Accession Number14962427
Keywords*Postoperative Complications, Bacteria / drug effects / *isolation & purification, Drug Resistance, Bacterial, Endophthalmitis / *microbiology, Humans, Keratoplasty, Penetrating / *adverse effects, Microbial Sensitivity Tests, Vitreous Body / microbiology

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.

URLinternal-pdf://Kunimoto - Endophthalmitis-3182236416/Kunimoto - Endophthalmitis.pdf
DOI10.1016/S0002-9394(03)00874-2 S0002939403008742 [pii]
Notify Library Reference ID848

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