Shilpa Kodati1, Andrew W Eller1, Regis P Kowalski1. 1. The Charles T. Campbell Ophthalmic Microbiology Laboratory and Retina Service, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Abstract
PURPOSE: To investigate the in vitro susceptibility of Gram-positive and Gram-negative endophthalmitis bacterial isolates to vancomycin, amikacin, and ceftazidime over a 23-year period. DESIGN: Retrospective non-comparative laboratory case series. SUBJECTS: Endophthalmitis patients that were culture positive for bacteria. METHODS: Laboratory records of bacteria isolated from endophthalmitis specimens collected from January 1st 1993 to December 31st 2015 were reviewed for incidence and standard susceptibility testing. MAIN OUTCOME MEASURES: The in vitro susceptibilities of bacteria cultured from endophthalmitis to vancomycin (VAN), amikacin (AMK), and ceftazidime (CEF). RESULTS: Patients with endophthalmitis were culture positive for bacteria in 665 cases.. Coagulase negative Staphylococci (CoNS) were the most common bacteria (54.6%), followed by Streptococci (Strep) species (20.8%), Staphylococcus aureus (SA) (10.2%), other Gram-positive (other-GP) bacteria (7.4%) and Gram-negative (GN) bacteria (7.1%). All Gram-positive organisms were susceptible to VAN, with the exception of 2 isolates. The in vitro susceptibilities of bacteria to AMK were: CoNS (95.3%), SA (75.0%), Strep (8.0%), GN (95.7%), and other-GP (81.1%). The in vitro susceptibilities of bacteria to CEF were: CoNS (58.5%), SA (54.4%), Strep (84.1%), GN (93.6.%), and other-GP (52.8%). There was no difference between AMK (95.7%) and CEF (93.6%) for GN coverage. AMK provided better coverage than CEF for CoNS, SA, and other-GP bacteria respectively (p<0.05, Fisher's exact), however, CEF appeared to provide better coverage (p<0.001, Fisher's exact) for Strep than AMK. CONCLUSIONS: Based on standard in vitro susceptibility testing, vancomycin remains an optimal antibiotic choice for the treatment of Gram-positive endophthalmitis. AMK and CEF appear to provide equal GN coverage, but AMK appears to provide better coverage for CoNS, SA, and other-GP, but not Strep.
PURPOSE: To investigate the in vitro susceptibility of Gram-positive and Gram-negative endophthalmitis bacterial isolates to vancomycin, amikacin, and ceftazidime over a 23-year period. DESIGN: Retrospective non-comparative laboratory case series. SUBJECTS:Endophthalmitispatients that were culture positive for bacteria. METHODS: Laboratory records of bacteria isolated from endophthalmitis specimens collected from January 1st 1993 to December 31st 2015 were reviewed for incidence and standard susceptibility testing. MAIN OUTCOME MEASURES: The in vitro susceptibilities of bacteria cultured from endophthalmitis to vancomycin (VAN), amikacin (AMK), and ceftazidime (CEF). RESULTS:Patients with endophthalmitis were culture positive for bacteria in 665 cases.. Coagulase negative Staphylococci (CoNS) were the most common bacteria (54.6%), followed by Streptococci (Strep) species (20.8%), Staphylococcus aureus (SA) (10.2%), other Gram-positive (other-GP) bacteria (7.4%) and Gram-negative (GN) bacteria (7.1%). All Gram-positive organisms were susceptible to VAN, with the exception of 2 isolates. The in vitro susceptibilities of bacteria to AMK were: CoNS (95.3%), SA (75.0%), Strep (8.0%), GN (95.7%), and other-GP (81.1%). The in vitro susceptibilities of bacteria to CEF were: CoNS (58.5%), SA (54.4%), Strep (84.1%), GN (93.6.%), and other-GP (52.8%). There was no difference between AMK (95.7%) and CEF (93.6%) for GN coverage. AMK provided better coverage than CEF for CoNS, SA, and other-GP bacteria respectively (p<0.05, Fisher's exact), however, CEF appeared to provide better coverage (p<0.001, Fisher's exact) for Strep than AMK. CONCLUSIONS: Based on standard in vitro susceptibility testing, vancomycin remains an optimal antibiotic choice for the treatment of Gram-positive endophthalmitis. AMK and CEF appear to provide equal GN coverage, but AMK appears to provide better coverage for CoNS, SA, and other-GP, but not Strep.
Authors: Michelle C Callegan; Michael Engelbert; David W Parke; Bradley D Jett; Michael S Gilmore Journal: Clin Microbiol Rev Date: 2002-01 Impact factor: 26.132
Authors: David Assaad; David Wong; Mikel Mikhail; Sherri Tawfik; Filiberto Altomare; Alan Berger; David Chow; Louis Giavedoni Journal: Can J Ophthalmol Date: 2015-12 Impact factor: 1.882
Authors: Nidhi Relhan; Thomas A Albini; Avinash Pathengay; Ajay E Kuriyan; Darlene Miller; Harry W Flynn Journal: Br J Ophthalmol Date: 2015-12-23 Impact factor: 4.638
Authors: Ronald C Gentile; Salil Shukla; Mahendra Shah; David C Ritterband; Michael Engelbert; Andrew Davis; Dan-Ning Hu Journal: Ophthalmology Date: 2014-04-02 Impact factor: 12.079
Authors: Asad F Durrani; Peter Y Zhao; Yunshu Zhou; Michael Huvard; Lyna Azzouz; Jason M Keil; Stephen T Armenti; Vaidehi S Dedania; David C Musch; David N Zacks Journal: Clin Ophthalmol Date: 2021-05-18