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X. Chen, R. A. Adelman; Pathogen Identity and Sensitivity in Endophthalmitis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6049.
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To study the microbial spectrum and sensitivity in endophthalmitis at a tertiary referral center in Northeast United States. Such knowledge may help physicians make more informed decisions about empiric treatments for endophthalmitis.
All vitreous samples sent to the microbiology laboratory from 1987 to 2009 were reviewed. Isolate sensitivity from 1987-1998 and 1999-2009 were compared. The identity and antimicrobial sensitivity of all isolates were analyzed using Microsoft Excel and Mathworks Matlab software.
A total of 165 isolates were yielded from 147 positive cultures sent to the microbiology laboratory. The most common organisms grown were coagulase-negative Staphylococcus (38%), Viridans Streptococcus (10%) and Streptococcus pneumoniae (7%). The organisms were 81% gram-positive, 12% gram-negative and 7% fungal. Staphylococcus and Streptococcus formed 42% and 24% of all organisms, respectively. Overall, organisms were most sensitive to vancomycin, TMP/SMX, tetracycline, clindamycin, ceftriaxone and chloramphenicol. Gram-positive bacteria had > 80% sensitivity to vancomycin, tetracycline, rifampin, gentamicin, clindamycin, ceftriaxone and chloramphenicol. Staphylococcus strains had > 80% sensitivity to vancomycin, TMP/SMX, tetracycline, rifampin, gentamicin, clindamycin and chloramphenicol, while Streptococcus had > 80% sensitivity to ceftriaxone, clindamycin, penicillin and vancomycin. Comparing the 90 isolates collected in 1987-1998 with the 75 collected in 1999-2009, a trend in decreased sensitivity was seen in cefazolin, erythromycin, penicillin, tetracycline and TMP/SMX, and a trend in increased sensitivity was seen in chloramphenicol and gentamicin.
The most common organisms were coagulase-negative Staphylococcus, Viridans Streptococcus and Streptococcus pneumoniae. Most organisms were gram-positive followed by gram-negative and then fungal. Staphylococcus formed the largest genus followed by Streptococcus. The decrease in sensitivity for cefazolin, erythromycin, penicillin, tetracycline and TMP/SMX is important in light of increasing drug resistance.
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