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Karsten U. Kortuem, Yazmin Yactayo-Miranda, Fabian Schwarzbach, Martin M. Nentwich, Marcus Kernt, Anselm Kampik, Herminia Mino de Kaspar; Spectrum Of Isolated Microorganisms And Their Antibiotic Resistance Pattern In Postoperative Endophthalmitis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6193.
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To demonstrate the spectrum of isolated microorganisms and their antibiotic resistance pattern in all cases of acute, chronic or recurrent postoperative endophthalmitis treated in our hospital.
A retrospective review of 123 patients (123 eyes) with postoperative treated in our hospital from January 2002 to January 2011 was done based on hospital charts and records from the microbiology laboratory of our hospital. In this investigation the spectrum of isolated microorganisms, antibiogram and time of onset of endophthalmitis were studied.
Ninety-nine patients had been transferred to our hospital for treatment of postoperative endophthalmitis after surgery elsewhere, while 24 patients had previous surgery at our institution. In 93 out of 99 external cases cataract surgery had been performed, while endophthalmitis was attributed to previous cataract surgery in 10 of 24 cases at our institution. The most commonly isolated microorganisms in patients with postoperative endophthalmitis were Coagulase negative Staphylococcus (CNS) (n = 41; 33%); Streptococci (n = 34; 28%); Staphylococcus aureus (n = 5; 4%), Propionibacterium acnes (n = 4; 3%) and others (n = 7; 6%). In 32 cases (26%), no microorganisms could be isolated. Figures 1 and 2 show the results of antibiotic sensitivity testing for Coagulase negative Staphylococcus and Streptococci. Median time of onset of symptoms was 4.0 days for patients after surgery at our institution and 5.0 days after surgery elsewhere. In 12 cases late-onset endophthalmitis (>90 days after surgery) was seen.
In our review of 123 cases of postoperative endophthalmitis we found more antibiotic resistances in CNS than in Streptococci. The later were mostly sensitive to antibiotics of the penicillin, cephalosporin, fluoroquinolone and macrolide types, however CNS showed resistance in more cases. On the other hand, Streptococci were more resistant to aminoglycoside antibiotics than CNS. We did not find any resistance to vancomycin.
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