A M Berrocal1, I U Scott, D Miller, H W Flynn. 1. Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida, USA.
Abstract
PURPOSE: To report the incidence, clinical presentation, antibiotic sensitivities, and treatment outcomes for endophthalmitis caused by Moraxella species. METHODS: Consecutive interventional case series. Medical records were reviewed of all patients treated at Bascom Palmer Eye Institute between 1991 and 2000 for endophthalmitis caused by Moraxella species. RESULTS: Moraxella species were recovered from 9 patients (10 eyes), or 1.3% (10 of 757) of all culture-proven bacterial endophthalmitis cases; Moraxella catarrhalis was recovered from 7 eyes and Moraxella osloensis from 3. Endophthalmitis was delayed-onset (5 months to 10 years postoperatively) and bleb-associated in 9 eyes and trauma-related in 1. All isolates were sensitive to ceftazidime, ciprofloxacin, and the aminoglycosides, and they were resistant to vancomycin; resistance to ampicillin and trimethoprim/sulfa was 11%. Although presenting vision was hand motion or worse in 7 of 10 eyes, all but 3 regained baseline visual acuity (including two eyes in which the post-treatment course was complicated by retinal detachment and one eye with coexistent traumatic injuries). CONCLUSION: Endophthalmitis caused by Moraxella species is usually delayed-onset and bleb-associated. Although patients usually present with a profound decrease in vision, the organisms are sensitive to most antibiotics and, unlike most series of delayed-onset bleb-associated endophthalmitis, visual outcomes are generally good unless coexistent ocular morbidities exist.
PURPOSE: To report the incidence, clinical presentation, antibiotic sensitivities, and treatment outcomes for endophthalmitis caused by Moraxella species. METHODS: Consecutive interventional case series. Medical records were reviewed of all patients treated at Bascom Palmer Eye Institute between 1991 and 2000 for endophthalmitis caused by Moraxella species. RESULTS:Moraxella species were recovered from 9 patients (10 eyes), or 1.3% (10 of 757) of all culture-proven bacterial endophthalmitis cases; Moraxella catarrhalis was recovered from 7 eyes and Moraxella osloensis from 3. Endophthalmitis was delayed-onset (5 months to 10 years postoperatively) and bleb-associated in 9 eyes and trauma-related in 1. All isolates were sensitive to ceftazidime, ciprofloxacin, and the aminoglycosides, and they were resistant to vancomycin; resistance to ampicillin and trimethoprim/sulfa was 11%. Although presenting vision was hand motion or worse in 7 of 10 eyes, all but 3 regained baseline visual acuity (including two eyes in which the post-treatment course was complicated by retinal detachment and one eye with coexistent traumatic injuries). CONCLUSION:Endophthalmitis caused by Moraxella species is usually delayed-onset and bleb-associated. Although patients usually present with a profound decrease in vision, the organisms are sensitive to most antibiotics and, unlike most series of delayed-onset bleb-associated endophthalmitis, visual outcomes are generally good unless coexistent ocular morbidities exist.
Authors: D Wilkin Parke; Avinash Pathengay; Harry W Flynn; Thomas Albini; Stephen G Schwartz Journal: J Ophthalmol Date: 2012-04-26 Impact factor: 1.909