In vitro Sensitivity of Organisms Responsible for Intraocular Foreign Body Associated Endophthalmitis

Abstract

Abstract: : Purpose: To evaluate the in-vitro sensitivity of organisms causing intra-ocular foreign body (IOFB) associated endophthalmitis. Methods: The microbiologic records of sixty-one consecutive eyes that presented to The New York Eye and Ear Infirmary with retained intra-ocular foreign bodies between Jan 1999 and July 2002 were reviewed. In vitro sensitivities were performed on all positive cultures and compared to NCCLS standards Results: Sixty-one eyes presented with intra-ocular foreign body. 25 of 34 eyes sampled (74%) had positive intra-ocular cultures. 27 eyes had no cultures performed. Minimum inhibitory concentrations were tabulated for all organisms using a VITEK II (BioMerieux) or by Kirby Bauer method. 21 eyes yielded gram-positive isolates, 3 eyes had gram-negative isolates, and one isolate was yeast. The relative efficacy of antibiotics against the gram-positive species based on MIC data was in descending order vancomycin (21/21)> ciprofloxacin (20/21)> gentamicin (19/21)> clindamycin (18/21)> erythromycin (12/21). The relative efficacy of antibiotics against the gram-negative species in descending order was ceftazidime (3/3)> gentamicin (2/3)> ciprofloxacin (2/3). Conclusions: Vancomycin and ceftazidime had 100% coverage of all organisms isolated following IOFB associated endophthalmitis. This combination of intra-ocular antibiotics has excellent in vitro coverage of organisms recovered in IOFB associated endophthalmitis.

Keywords: trauma • endophthalmitis • antibiotics/antifungals/antiparasitics