March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Staphylococcus aureus Isolated from Endophthalmitis May Be Hospital-Acquired Based on PVL and Antibiotic Susceptibility Testing
Author Affiliations & Notes
  • Regis P. Kowalski
    Ophthalmology/Microbiology, University of Pittsburgh, Pittsburgh, PA, Pittsburgh, Pennsylvania
  • Tyler A. Kowalski
    Ophthalmology/Microbiology, University of Pittsburgh, Pittsburgh, PA, Pittsburgh, Pennsylvania
  • Kristin A. Rarey
    Ophthalmology/Microbiology, University of Pittsburgh, Pittsburgh, PA, Pittsburgh, Pennsylvania
  • Robert M. Shanks
    Ophthalmology/Microbiology, University of Pittsburgh, Pittsburgh, PA, Pittsburgh, Pennsylvania
  • Eric G. Romanowski
    Ophthalmology/Microbiology, University of Pittsburgh, Pittsburgh, PA, Pittsburgh, Pennsylvania
  • Francis S. Mah
    Ophthalmology/Microbiology, University of Pittsburgh, Pittsburgh, PA, Pittsburgh, Pennsylvania
  • Footnotes
    Commercial Relationships  Regis P. Kowalski, None; Tyler A. Kowalski, None; Kristin A. Rarey, None; Robert M. Shanks, None; Eric G. Romanowski, None; Francis S. Mah, None
  • Footnotes
    Support  Pennsylvania Lions Club
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 1690. doi:
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      Regis P. Kowalski, Tyler A. Kowalski, Kristin A. Rarey, Robert M. Shanks, Eric G. Romanowski, Francis S. Mah; Staphylococcus aureus Isolated from Endophthalmitis May Be Hospital-Acquired Based on PVL and Antibiotic Susceptibility Testing. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1690.

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Abstract

Purpose: : Staphylococcus aureus (SA) endophthalmitis is generally a post-surgical infection with an undefined source of entry. Hospital-acquired (HA) infections are associated with multi-antibiotic resistance and not possessing the Panton Valentine Leukocidin (PVL) toxin. Community-acquired (CA) infections are not associated with multi-antibiotic resistance and possess PVL toxin. We hypothesize that CA infection is more common than HA for Staphylococcus aureus endophthalmitis.

Methods: : Twenty de-identified SA isolates, collected from the vitreous and/or aqueous of clinical endophthalmitis, were tested for the presence of PVL toxin and antibiotic susceptibility. PVL testing was performed using a kit to detect the staphylococcal toxin by reversed passive latex agglutination (PVL-RPLA "Seiken", Denka Seiken Co., LTD, Japan) and PCR (targets lukF-PV and lukS-PV genes). SA isolates were tested for antibiotic susceptibility using disk diffusion at the time of isolation. Multi-antibiotic resistance was defined as resistance to at least 3 classes of antibiotics.

Results: : Of the 20 isolates (PVL-RPLA testing), 15 were multi-antibiotic resistant and PVL-negative consistent with HA, and 1 was not multi-antibiotic resistant and PVL-positive, consistent with CA. Only two isolates tested positive for PVL with one demonstrating methicillin (MR) and fluoroquinolone (FQ) resistance. Of the 18 PVL-negative SA isolates, 15 (83%) were multi-antibiotic resistant (12 MRSA, 14 FQ resistant). All SA isolates tested PVL negative by PCR.

Conclusions: : Our results reject the hypothesis that Staphylococcus aureus isolated from endophthalmitis is consistent with CA sources due to the lack of the PVL toxin and multiple resistant patterns of the SA. PVL does not appear to be a key virulence factor for the development of SA endophthalmitis.

Keywords: Staphylococcus • endophthalmitis • antibiotics/antifungals/antiparasitics 
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