May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Endophthalmitis After Clear Corneal Cataract Surgery: Fluoroquinolone Resistant Isolates
Author Affiliations & Notes
  • C. R. Alabiad
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • D. Miller
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • G. A. Lalwani
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • H. W. Flynn
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • Footnotes
    Commercial Relationships C.R. Alabiad, None; D. Miller, None; G.A. Lalwani, None; H.W. Flynn, Alcon, C; Eli Lilly, C; Eyetech, C; Genentech, C; Novartis, C; Optimedica, C; Pfizer, C.
  • Footnotes
    Support Supported by NIH center grant P30 EY014801 and by an unrestricted grant to the University of Miami from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 680. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      C. R. Alabiad, D. Miller, G. A. Lalwani, H. W. Flynn; Endophthalmitis After Clear Corneal Cataract Surgery: Fluoroquinolone Resistant Isolates. Invest. Ophthalmol. Vis. Sci. 2007;48(13):680.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose:: To investigate the visual acuity outcomes and antibiotic sensitivity profiles in cases of endophthalmitis resulting from fluoroquinolone resistant organisms (FROs).

Methods:: The clinical and microbiological records were reviewed of all patients with clinically diagnosed endophthalmitis within 6 weeks after cataract surgery at the Bascom Palmer Eye Institute between January 1996 and December 2005. Antimicrobial sensitivities of organisms cultured from patients with endophthalmitis were established via the e-test and the disk diffusion technique. In-vitro fluoroquniolone resistant isolates were identified. FROs were defined as a resistance to either ciprofloxacin, levofloxacin, moxifloxacin, or gatifloxacin. A favorable visual acuity outcome was defined as a final visual acuity (VA) of 20/40 or better.

Results:: In the current study, 73 patients with culture positive endophthalmitis after cataract surgery were identified over the ten year period. 24/73 isolates (32.9%) were associated with FROs. This subgroup of patients was comprised of 9 women and 15 men (mean age+SD; 81+7.6 years) with a visual acuity of 20/50 or worse at the time of diagnosis. All cases associated with FROs were diagnosed by community ophthalmologists and referred to our institution for treatment. The average time (days+SD) between cataract surgery and the clinical diagnosis of endophthalmitis was 14+12 days. In the FRO group, Staphylococcus epidermidis was isolated in 22/24 (91.7%) while Staphylococcus aureus was isolated in 2/24 (8.3%). Fluoroquinolone resistant Staphylococcal isolates were also resistant to methicillin in 22/24 (91.7%), gentamicin in 11/24 (46%), sulfamethoxazole in 8/24 (33%), and erythromycin in 18/23 (79%) tested isolates. All isolates were sensitive to vancomycin. A favorable visual acuity outcome (VA≥20/40) was achieved in 12/24 (50%) of the FRO group compared to 24/49 (49%) of the non-FRO group.

Conclusions:: Fluoroquinolone resistance occured in 32.9% of endophthalmitis isolates after cataract surgery. All isolates were sensitive to vancomycin. Visual outcomes among patients with endophthalmitis from FROs and non-FROs were similar.

Keywords: endophthalmitis • antibiotics/antifungals/antiparasitics • Staphylococcus 
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×