Abstract
Purpose: :
To investigate the microbial spectrum and sensitivities of isolates to newer and established antibiotics in culture–proven endophthalmitis following cataract surgery.
Methods: :
The study concerns culture–proven postoperative endophthalmitis after cataract surgery referred to our center between January 2001 and December 2004. One hundred and twenty–eight micro organisms were isolated (125 bacteria and 3 fungi) from anterior–chamber paracentesis in 110 patients. Bacteria were identified to the species–level and the antibiotic susceptibility profiles were determined using the NCCLS–approved reference disk diffusion method. Isolates were tested for their sensitivity to oxacillin (OX), ceftazidime (C3G), imipenem (IMI), gentamicin (GEN), tobramycin (TOB), ciprofloxacin (CIP), moxifloxacin (MOX), rifamycin (RIF), vancomycin (VAN), fosfomycin (FOS).
Results: :
One hundred ten (52%) of 212 samples were culture positive and 18 (16.4%) cases among culture–positive cases were polymicrobial, yielding a total of 128 isolates. The 3 most frequent gram–positive bacteria recovered were coagulase–negative Staphylococcus in 58 cases (45.3%), Streptococcus viridans group in 22 cases (17.2%) Streptococcus viridans group and Propionibacterium acnes in 22 cases (17.2%). Gram–negative bacilli and Aspergillus sp were recovered in 6 (4.7%) and 3 (2.3%) cases respectively. The percentage of coagulase–negative Staphylococcus isolates susceptible to selected antibiotics was: OXA 88%, GEN 96,5%, TOB 82,8%, IMI 88%, CIP 82,8%, FOS 75,9%, RIF 98,3%, VAN 100%. The percentage of susceptibility was: GEN 54%, RIF 100%, VAN 100%, CIP %, 41%, MOX 100% for Propionibacterium acnes. In addition, all Streptococcus viridans group isolates were susceptible to MOX.
Conclusions: :
This study reports a high prevalence of gram–positive species and suggests that most of the bacteria were in vitro susceptible to established and narrow spectrum antibiotics. In addition, moxifloxacin demonstrated an excellent in vitro activity against Streptococcus viridans group and Propionibacterium acnes. Commercial relationship: none.
Keywords: endophthalmitis • antibiotics/antifungals/antiparasitics • cataract