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Jonathan S. Chang, Harry W. Flynn, Jr., Darlene Miller; Stenotrophomonas maltophilia Endophthalmitis Following Cataract Surgery; Clinical and Microbiological Results. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5607.
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To evaluate microbiological sensitivities, clinical characteristics and treatment outcomes in patients with endophthalmitis caused by Stenotrophomonas maltophilia following cataract surgery.
Retrospective case review of records from January 1, 1990 - June 30, 2010 at the Bascom Palmer Eye Institute (BPEI). Cases of S. maltophilia endophthalmitis were reviewed based on positive vitreous cultures in the BPEI microbiology records. Polymicrobial cases and cases not related to cataract surgery were excluded.
Of 1,345 positive vitreous cultures, nine cases of endophthalmitis from S. maltophilia were identified. Seven met inclusion criteria. In these cases, initial visual acuity ranged from 20/200-LP. Time to diagnosis was 2 to 118 days. Treatments were either tap and inject (5) or pars plana vitrectomy with intravitreal antibiotics (2) as per the EVS. All seven isolates were sensitive to ceftazidime, and resistant to gentamycin and imipenim. Five of seven isolates were sensitive to ciprofloxacin and four of seven were sensitive to tobramycin. Two of four tested isolates were sensitive to trimethoprim-sulbactam.All patients received intravitreal ceftazidime as part of the initial treatment regimen. Five of the seven patients received dexamethasone. Two patients developed recurrent infections. Final visual acuity ranged from 20/25 to 4/200 (five patients with vision 20/150 or better, one with 20/300 and one with 4/200). The patients who underwent vitrectomy had final vision 4/200 and 20/30. The five tap and inject patients had final visual acuity between 20/25 to 20/300.
We report a series of endophthalmitis from S. maltophilia, a rare source of infection following cataract surgery. Antimicrobial resistance profiles in these cases showed sensitivity to ceftazidime and mixed sensitivity to other antibiotics. Visual outcomes in these cases demonstrated vision better than 20/150 in the majority of cases.
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