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K. T. Wals, R. P. Kowalski, R. L. Bergren, A. W. Eller; Etiologies of Gram Negative Endophthalmitis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):701.
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To describe the underlying etiologies of cases of gram negative endophthalmitis, as well as to characterize the susceptibility patterns of these organisms.
A retrospective chart review was performed on all cases of gram negative endophthalmitis logged into the database at the Charles Campbell Microbiology Laboratory at the UPMC Eye Center, University of Pittsburgh School of Medicine, between January 1, 1990, and October 12, 2006. Information was collected on clinical events contributing to the infection, bacterial species, and antibiotic susceptibility. The clinical events were categorized as surgical, traumatic, or endogenous. The surgical category was specifically evaluated for cases of recent (within 1 week) cataract surgery. Complications from infectious keratitis were excluded.
Of 24 cases reviewed, there were 17 cases of endophthalmitis, and 7 cases of infectious keratitis, which were excluded. Of these 17, 11 (64.7%) were surgical, 4 (23.5%) were traumatic, and 2 (11.8%) were from an endogenous source. Only 5 (29.4%) of the surgical cases were due to recent cataract surgery. Of the 18 organisms cultured, only 2 (11.1%) were susceptible to vancomycin, whereas all but 1 (94.4%) were susceptible to ceftazidime (intermediate), and all but 2 (88.9%) were susceptible to amikacin (1 intermediate, 1 resistant).
Gram negative endophthalmitis was infrequently related to recent cataract surgery. These organisms were nearly all susceptible to both ceftazidime and amikaxin, and most were resistant to vancomycin.
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