July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Clinical characteristics, outcome, and management of Staphylococcus epidermidis endophthalmitis
Author Affiliations & Notes
  • Tatiana Tanaka
    Ophthalmology, University of São Paulo, Brazil
  • Juliana Mika Kato
    Ophthalmology, University of São Paulo, Brazil
  • Luiza Manhezi Shin de Shin de Oliveira
    Ophthalmology, University of São Paulo, Brazil
  • Eduardo Ferracioli Oda
    Ophthalmology, University of São Paulo, Brazil
  • Thaisa Silveira Barbosa
    Ophthalmology, University of São Paulo, Brazil
  • Flavia Rossi
    Microbiology, University of São Paulo, Brazil
  • Joao Nobrega Almeida Junior
    Microbiology, University of São Paulo, Brazil
  • Joyce Hisae Yamamoto
    Ophthalmology, University of São Paulo, Brazil
  • Footnotes
    Commercial Relationships   Tatiana Tanaka, None; Juliana Kato, None; Luiza Shin de Oliveira, None; Eduardo Oda, None; Thaisa Barbosa, None; Flavia Rossi, None; Joao Almeida Junior, None; Joyce Yamamoto, None
  • Footnotes
    Support  NONE
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2027. doi:
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      Tatiana Tanaka, Juliana Mika Kato, Luiza Manhezi Shin de Shin de Oliveira, Eduardo Ferracioli Oda, Thaisa Silveira Barbosa, Flavia Rossi, Joao Nobrega Almeida Junior, Joyce Hisae Yamamoto; Clinical characteristics, outcome, and management of Staphylococcus epidermidis endophthalmitis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2027.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Staphylococcus epidermidis is the most commonly isolated pathogen in endophthalmitis. Diagnosis and treatment guidelines are based primarily on experience derived from endophthalmitis treatment following cataract surgery. In this study we investigated infectious endophthalmitis caused by S. epidermidis for differences in clinical course, interventional measures, and prognosis.

Methods : This retrospective study included 20 cases of endophthalmitis caused by S. epidermidis and treated between October 2015 and July 2017 at the Department of Ophthalmology, Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil. We analyzed cases according to the type of intervention, time elapsed before diagnosis,diagnosis, and post-intervention visual acuity. This study was approved by the Institutional Ethics Committee.

Results : Of the 20 eyes of 20 patients included in this study, 13 cases of endophthalmitis were associated with phacoemulsification (65%), 1 with extracapsular cataract extraction (5%), 3 with intravitreal injection (15%), 2 with suture removal (10%) and 1 with vitrectomy (5%). Symptoms for all cases presented at a mean of 4.5 days. A vitreous tap and injection with antibiotics were performed as initial treatment in 14 of 20 eyes ( 70%) and pars plana vitrectomy was performed as initial treatment in 6 of 20 eyes (30%). In public healthcare settings vitreous tap and injection were the initial treatments in 13 of 14 eyes (92.8%), and in private healthcare settings, pars plana vitrectomy was the initial treatment in 5 of 7 eyes (71.4%).
All isolates were sensitive to vancomycin and linezolid. Visual acuity was good (20/200 or better) in 14 of 20 eyes (70%). Susceptibility to methicillin, and moxifloxacin and ciprofloxacin was present in 16 of 20 eyes (80%), and 17 of 20 eyes (85%), respectively. Final visual acuity was not significantly different between those eyes that were methicillin or fluoroquinolone sensitive, and those that were resistant. (p<0.05)

Conclusions : S. epidermidis was sensitive to vancomycin and linezolid. Visual acuity outcomes were not dependent on initial treatment procedure (vitrectomy or tap and injection) or on methicillin or fluoroquinolone sensitivity. This single pathogen case series provides a better understanding of the aggressiveness of S. epidermidis.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

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