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S. Chhabra, D.Y. Kunimoto, C.D. Regillo, A.C. Ho, J. Belmont, J. Maguire, G.C. Brown; The Microbiologic Spectrum of Endophthalmitis After Open Globe Injuries . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5290.
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To present the microbiologic spectrum and susceptibility data from ten consecutive cases of culture–proven posttraumatic endophthalmitis seen at one institution, and to provide a review of the literature.
A review of 1182 consecutive cases of open globe injuries presenting to Wills Eye Hospital between 1990 – 2001 was conducted. From this data set, ten eyes from ten patients with clinically evident, culture–proven endophthalmitis were identified. The culture and susceptibility data from these cases was analyzed, and compared to the microbiologic data previously reported in thirteen publications on posttraumatic endophthalmitis.
A total of thirteen organisms were identified from cultures of ten eyes. Streptococcus species was isolated most frequently (six of thirteen isolates, or 46.2%), followed by coagulase–negative Staphylococcus (three isolates, or 23.1%), and Bacillus cereus (two isolates, or 15.4%). Susceptibilty testing revealed moderate resistance to ampicillin, ciprofloxicin, erythromycin, naficillin, penicillin, and sulfa antibiotics. All organisms tested were susceptible to vancomycin and tobramycin. Combining our data with thirteen previous reports on posttraumatic endophthalmitis yielded a total data set of 233 cases of culture–proven endophthalmitis. The most common organisms isolated from this data set were coagulase–negative Staphylococcus (25.3%) and Bacillus cereus (22.3%).
We report a high incidence of gram–positive pathogens in posttraumatic endophthalmitis, and a smaller segment of gram–negative pathogens. Susceptibility results suggest that vancomycin and tobramycin can provide broad empiric coverage for posttraumatic endophthalmitis.
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