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The Susceptibility of Bacterial Endophthalmitis Isolates to Vancomycin, Ceftazidime, and Amikacin: a 23 Year-Review.
Kodati, Shilpa; Eller, Andrew W; Kowalski, Regis P.
Affiliation
  • Kodati S; The Charles T. Campbell Ophthalmic Microbiology Laboratory and Retina Service, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
  • Eller AW; The Charles T. Campbell Ophthalmic Microbiology Laboratory and Retina Service, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
  • Kowalski RP; The Charles T. Campbell Ophthalmic Microbiology Laboratory and Retina Service, UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Ophthalmol Retina ; 1(3): 206-209, 2017.
Article in En | MEDLINE | ID: mdl-28845474
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.

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Ophthalmol Retina Year: 2017 Document type: Article Affiliation country: Panama

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Ophthalmol Retina Year: 2017 Document type: Article Affiliation country: Panama