Endophthalmitis after Penetrating Keratoplasty: Microbiologic Spectrum and Susceptibility of Isolates

Abstract

Abstract: : Purpose: To present the microbial spectrum and susceptibilities of isolates in post-penetrating keratoplasty endophthalmitis. Methods: 1074 consecutive cases of endophthalmitis presenting to Wills Eye Hospital between 1989 and 2000 were reviewed. 14 patients with endophthalmitis after penetrating keratoplasty were identified, and vitreous biopsy isolates from these patients were examined. Results: 11 (78.6%) of 14 vitreous samples were culture-positive, and 2 others (14.3%) had organisms viewed on pathology specimen, for a total of 13 (92.9%) organism-proven cases of endophthalmitis. Isolates included 10 (76.9%) gram-positive cocci (8 Streptococcus sp, 3 Staphylococcus sp, 1 identified on pathology specimen only) and 3 (23.1%) gram-negative organisms (Proteus mirabilis, Serratia marcescens, 1 identified on pathology specimen only). Susceptibilities to organism-appropriate antibiotic testing are reported, including cefazolin (6 of 8, 75.0%), ciprofloxacin (3 of 7, 42.9%), nafcillin (4 of 6, 66.7%), and vancomycin (8 of 8, 100.0%). Conclusions: This is the largest, single-center series on microbial susceptibilities in post-penetrating keratoplasty endophthalmitis. We report a high percentage of culture-positivity, and a high incidence of gram-positive species, and in particular Streptococcus species, with all testing susceptible to vancomycin.

Keywords: endophthalmitis • clinical (human) or epidemiologic studies: nat