May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Endophthalmitis Caused by Klebsiella species
Author Affiliations & Notes
  • N. Matharoo
    Ophthalmology, University of Miami School of Medicine, Miami, FL
  • Footnotes
    Commercial Relationships  N. Matharoo, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 513. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      N. Matharoo; Endophthalmitis Caused by Klebsiella species . Invest. Ophthalmol. Vis. Sci. 2004;45(13):513.

      Download citation file:


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

      ×
  • Supplements
Abstract

Abstract: : Purpose: To investigate clinical settings, antibiotic sensitivities, and visual acuity outcomes of endophthalmitis caused by Klebsiella species. Methods: Records were reviewed of all patients with endophthalmitis caused by Klebsiella treated at one institution between 1984 and 2003. Main outcome measures include visual acuity and antibiotic sensitivities. Results: 6 eyes of 6 patients met study inclusion criteria; endophthalmitis was caused by Klebsiella pneumoniae in 5 eyes and Klebsiella oxytoca in 1 eye. The median follow–up was 6 months (range, 4 to 9 months). Clinical settings included acute–postoperative following cataract surgery, (2 eyes; both cases were complicated by intraoperative vitreous loss), trauma (2), perforated corneal ulcer (1), and endogenous associated with hepatic abscess (1). Five cases (71%) were acute–onset (less than 3 weeks from surgery/event), with a median interval between surgery/event and presentation of endophthalmitis of 4 days (range, 1 day to 7 days). Pretreatment vision was hand motions or better in 4 (67%) eyes. Initial treatment was vitreous tap and injection of intravitreal antibiotics in 2 (33%) eyes, pars plana vitrectomy and injection of intravitreal antibiotics in 3 (50%) eyes, and evisceration in 1 (17%) eye with no light perception. 2 eyes (33%) received intravitreal steroids, 4 (67%) received additional doses of intraocular antibiotics, and 1 (17%) underwent pars plana vitrectomy within 1 week of diagnosis. The Klebsiella oxytoca isolate was sensitive to gentamicin, sulfa–trimethoprim, and ciprofloxacin, and was resistant to ampicillin. The 5 Klebsiella pneumoniae isolates showed sensitivity patterns as follows: 4/5 (80%) gentamicin, 1/5 (20%) ancef, 3/5 (60%) cefazolin, 3/5 (60%) sulfa–trimethoprim, 2/5 (40%) pipercillin, 2/5 (40%) imipenem, 2/5 (40%) amikacin, 1/5 (20%) chloromycetin, 1/5 (20%) neomycin, 1/5 (20%) polymixin, 1/5 (20%) tetracycline, 2/5 (40%) ciprofloxacin, 1/5 (20%) cefazolin and 1/5 (20%) levofloxacin. The 5 Klebsiella pneumoniae isolates showed resistance patterns as follows: 5/5 (100%) ampicillin, 1/5 (20%) carbenicillin, 1/5 (20%) cefazolin, and 1/5 (20%) ticarcillin. The organism was sensitive to at least one antibiotic administered initially in all cases. Final visual acuity was 20/400 or better in 2/6 (33%) cases, and light perception in 1/6 (17%) case. No case had a final visual acuity of 20/40 or better. Conclusion: Despite treatment with appropriate antibiotics, endophthalmitis caused by Klebsiella species is associated with poor visual acuity outcomes.

Keywords: endophthalmitis • visual acuity • bacterial disease 
×
×

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.

×