Spectrum of Aetiological Agents of Postoperative Endophthalmitis and Antibiotic Susceptibility of Bacterial Isolates

Indian J Ophthalmol. 2000 Jun;48(2):123-8.

Abstract

Purpose: To determine the spectrum of infectious agents of postoperative endophthalmitis, the relationship with the time of onset of symptoms after surgery and the antibiotic susceptibilities of the aerobic bacterial isolates.

Methods: A retrospective review of microbiological records from January 1995 to December 1998 yielded 173 isolates from intraocular specimen of 170 patients with culture-proven postoperative endophthalmitis. Antibiotic susceptibility of these isolates was determined for various ocular antibiotics using the Kirby-Bauer disk-diffusion test. Based on the time of onset of illness, clinical presentation was classified into acute, delayed and chronic.

Results: Among 170 cases, 71 (41.7%) were attributable to gram-negative, 64 (37.6%) to gram-positive bacteria, and 37 (21.8%) to fungi. Gram-negative bacteria included P. aeruginosa (29;17.1%), other Pseudomonas spp (15;8.8%), non-fermenters (18;10.6%) and others (10;5.8%). Among these, 40 of 72 (55.5%) were sensitive to gentamicin, 47 of 72 (65.2%) to cefotaxime, 47 of 69 (68.1%) to amikacin, 52 of 71 (73.2%) to ciprofloxacin, and 25 of 40 (62.5%) to ceftazidime. The gram-positive bacteria included S. epidermidis (22;12.9%), S. aureus (13;7.6%), P. acnes (10;5.9%), Enterococcus spp (4;2.3%), Streptococcus spp (7;4.1%) and others (8;4.8%). Among these, 41 of 53 (77.3%) were sensitive to gentamicin, 47 of 53 (88.6%) to cefotaxime, 46 of 52 (88.4%) to ciprofloxacin, 38 of 41 (92.6%) to cefazolin and 27 of 37 (72.9%) to ceftazidime. All gram-positive bacteria were sensitive to vancomycin.

Conclusion: In this large series of postoperative endophthalmitis, gram-negative bacilli followed by fungi accounted for the largest number of cases. A high degree of resistance of gram-negative bacilli to gentamicin, cefotaxime, amikacin and ceftazidime was recorded.

Publication types

  • Comparative Study

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Endophthalmitis / drug therapy
  • Endophthalmitis / microbiology*
  • Eye Infections, Bacterial* / drug therapy
  • Eye Infections, Bacterial* / microbiology
  • Eye Infections, Fungal* / drug therapy
  • Eye Infections, Fungal* / microbiology
  • Fungi / drug effects*
  • Fungi / isolation & purification
  • Gram-Negative Bacteria / drug effects*
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Positive Bacteria / drug effects*
  • Gram-Positive Bacteria / isolation & purification
  • Humans
  • Microbial Sensitivity Tests
  • Retrospective Studies
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / microbiology
  • Vitreous Body / microbiology

Substances

  • Anti-Bacterial Agents