Abstract
Purpose: :
To evaluate the microbiological profile and treatment outcomes of vancomycin resistant gram- positive bacterial endophthalmitis
Methods: :
Medical records of consecutive patients with gram- positive bacterial endophthalmitis resistant to vancomycin (disc diffusion method) presenting between January 1, 2005 and December 31, 2010 were reviewed. Favourable outcome was defined as best corrected visual acuity greater or equal to 20/200.
Results: :
Out of 682 culture positive endophthalmitis isolates , 448/682(65.6%) were associated with gram- positive bacteria. In vitro resistance to vancomycin was noted in 7/448 (1.56%). Three cases were post-traumatic ,three were postoperative and one was endogenous in origin. Resistance was commonly noted in Bacillus spp (4/7, 57.14%), followed by Staphylococcus spp (2/7, 28.6%) and Enterococcus sp (1/7,14.3%). . These isolates in vitro were most sensitive to ciprofloxacin in 6/7 (85.7%) of patients. Presenting visual acuity was only light perception in all 7 cases. Favourable outcome was achieved in only 1/7 (14.3%) cases.
Conclusions: :
Vancomycin resistant endophthalmitis is rare and could be associated with poor visual outcome. Bacillus spp was the commonest gram positive bacteria resistant to vancomycin. Ciprofloxacin may be considered as an useful alternative in vancomycin
Keywords: endophthalmitis