Bacterial isolates and antimicrobial susceptibility pattern of ocular infection at a tertiary referral hospital in the South of Italy.

PURPOSE: The present study aimed to determine the prevalence of bacterial and fungal infections of the eye and also to assess the antibiotic susceptibility pattern of bacterial isolates at a tertiary referral eye care hospital in Bari, Italy. METHODS: Two hundred seventy three samples collected during a 2-year observation period. Culture, Gram's stain, potassium hydroxide mount and occasionally Giemsa staining was done for the clinical specimens. Antibiotic susceptibility testing was performed for bacterial growth. RESULTS: Out of 273 samples processed, 236 (86.4%) yielded growth: of them, 183 (77,5%) were bacterial, 26 (11%) fungal, and 23 (9,7%) specimens showed the presence of Acanthamoeba. Among bacterial infections, 99 (54.5%) bacterial isolates were Gram-positives, and 82 (44.8%) were Gram-negatives. Among Gram positives, Tigecycline showed the greatest susceptibility (93.8%), followed by Linezolid (97%) and Daptomycin (95.18%). Gram negative bacteria strains were susceptible to Imipenem (95%), Meropenem (98,5%) and Amikacin (91%) Multidrug in vitro resistance (resistance >3 classes of antibiotics) was found in 45 Gram positive (63%). and 33 Gram negative (44%). CONCLUSION: Conjunctival specimens yielded mainly bacterial growth with Staphylococcus species being the predominant isolate followed by Pseudomonas species. Findings from the current analysis evidence a substantial level of in vitro resistance to ≥3 antibiotics.

A 10-year-old immunocompetent girl with endogenous fungal endophthalmitis: Report of a case and review of the literature.

Endogenous Endophthalmitis (EE) is a rare cause of blindness in the pediatric age group and this may account for the paucity of management guidelines in the literature. In this report, we describe our experience with a 10-year-old immunocompetent female who developed EE and became blind because of rapidly progressive and destructive inflammatory changes in her eye in spite of seemingly timely treatment.

Validation of a new system for triage of ophthalmic emergencies: the alphabetical triage score for ophthalmology (ATSO).

PURPOSE: To propose a modified ophthalmic triage system based on simple ophthalmic symptoms, signs and anamnestic data and validate its safety and effectiveness. METHODS: Phase 1 of the study was a retrospective review of chart records of patients admitted at the ophthalmic emergencies room (OER); phase 2 was a prospective study conducted on all consecutive patients presenting in the OER between April 1st, 2018, and May 30th, 2018. We selected the following six factors as predictors of urgency levels: altered vision, ocular behavior, color, distress, eye trauma, floaters and flashes. ATSO final score can be eventually converted into risk groups: low-risk group (scoring 0-3), intermediate-risk group (scoring 4-5) and high-risk group (scoring > 6). RESULTS: A total of 953 consecutive patients who presented to our OER over a two-month period were considered for participation in the study. The male-to-female ratio was 1.24:1. The mean age of the participants was 53 years (range 18-92, SD 19 years). ATSO score significantly correlated with urgency levels (p < .00001). The sensitivity of ATSO in differentiating urgent from non-urgent conditions was 91.4%, and the specificity was 98.2%. All hospitalized patients (30, 3.15%) have been coded as intermediate/high risk according to the ATSO score. CONCLUSION: The use of the ATSO score for patients at the OER provides the clinician with a reliable predictor of urgency, being at the same time safe and effective. The ATSO score may represent a valuable tool to implement triage of ocular patients in the emergency department.