June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Clinical outcomes and management of endophthalmitis caused by Staphylococcus epidermidis: comparison of most recent decade with the prior decade[1]
Author Affiliations & Notes
  • Harry W Flynn
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Nicolas Alessandro Yannuzzi
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Nimesh Patel
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Nidhi Relhan
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Kimberly D Tran
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Nancy Si
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Darlene Miller
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Harry Flynn, None; Nicolas Yannuzzi, None; Nimesh Patel, None; Nidhi Relhan, None; Kimberly Tran, None; Nancy Si, None; Darlene Miller, None
  • Footnotes
    Support  The study was supported by the NIH Center Core Grant P30EY014801, an unrestricted grant to the University of Miami from National Eye Institute, a grant from the Research to Prevent Blindness, New York, New York, USA, and also the Department of Defense grant (DOD-Grant#W81XWH-13-1-0048
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3877. doi:
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      Harry W Flynn, Nicolas Alessandro Yannuzzi, Nimesh Patel, Nidhi Relhan, Kimberly D Tran, Nancy Si, Darlene Miller; Clinical outcomes and management of endophthalmitis caused by Staphylococcus epidermidis: comparison of most recent decade with the prior decade[1]. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3877.

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

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Abstract

Purpose : To report the clinical features, antibiotic susceptibilities, and visual acuity outcomes with endophthalmitis caused by methicillin-sensitive (MSSE) and methicillin-resistant (MRSE) Staphylococcus epidermidis.

Methods : Clinical and microbiology records were reviewed for 83 eyes of 83 patients who presented to a tertiary referral center between 2006 and 2015 with endophthalmitis caused by Staphylococcus epidermidis. The cohort was then compared to cases from the prior decade.1

Results : The most common clinical settings were following cataract surgery in 43/83 (52%) eyes, intravitreal injection (18/83, 22%, eyes), trauma (6/83, 7%, eyes), glaucoma surgery (5/83, 6%, eyes), and penetrating keratoplasty (5/83, 6%, eyes). The initial treatment included intravitreal vancomycin and ceftazidime in 76/83 (92%) eyes and intravitreal vancomycin and amikacin in 7/83 (8%) eyes. A vitreous tap and injection with antibiotics was performed as the initial treatment in 73/83 (88%) and pars plana vitrectomy in 10/83 (12%) eyes. All isolates were sensitive to vancomycin in both decades. In the most recent decade, visual acuity at last follow-up was ≥5/200 in 60/83 (72%) eyes. Isolates were sensitive to methicillin in 38/83 (46%) eyes and resistant in 45/83 (54%) eyes. Moxifloxacin sensitivity was 32% overall including 53% of MSSE and 15% of MRSE. In the prior decade, visual acuity at last follow-up was ≥5/200 in 71/86 (83%) eyes. Isolates were sensitive to methicillin in 34/86 (40%) eyes and resistant in 52/86 (60%) eyes. Moxifloxacin sensitivity was 68% overall including 73% of MSSE and 67% of MRSE.

Conclusions : In both decades, all Staphylococcus epidermidis isolates were sensitive to vancomycin. However, sensitivity to fluoroquinolones has dropped from 68% in the prior decade1 to 32% in the most recent decade. Visual acuity outcomes and methicillin sensitivity rates were similar between decades.

[1] Miller DM, Vedula AS, Flynn HW Jr et al. Endophthalmitis caused by Staphylococcus epidermidis: in vitro antibiotic susceptibilities and clinical outcomes. Ophthalmic Surg Lasers Imaging. 2007 Nov-Dec;38(6):446-51.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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