Endophthalmiti iolate and antibiotic enitivitie: a 6-year review of culture-proven cae

Purpoe To invetigate the pectrum of organim cauing culture-proven endophthalmiti and their enitivitie to commonly ued antimicrobial agent. Deign Retropective, noncomparative, conecutive cae erie. Method Medical record were reviewed of all patient with culture-proven endophthalmiti at a ingle intitution between January 1, 1996, and December 31, 2001. Endophthalmiti categorie included potoperative, pottraumatic, endogenou, and micellaneou (for example, keratiti). The outcome meaure included intravitreal iolate identified, antibiotic enitivitie, and category of endophthalmiti. Reult In all, 313 organim were iolated from 278 patient during the tudy interval. The mot common organim identified were taphylococcu epidermidi in 27.8% (87/313), treptococcu viridan group in 12.8% (40/313), other coagulae-negative taphylococci in 9.3% (29/313), taphylococcu aureu in 7.7% (24/313), and Propionibacterium acne in 7.0% (22/313). Overall, 246 of 313 (78.5%) iolate were gram-poitive organim, 37 (11.8%) were gram-negative organim, and 27 (8.6%) were fungi. For gram-poitive organim, enitivitie were the following: vancomycin 100%, gentamicin 78.4%, ciprofloxacin 68.3%, ceftazidime 63.6%, and cefazolin 66.8%. For gram-negative organim, enitivitie were the following: ciprofloxacin 94.2%, amikacin 80.9%, ceftazidime 80.0%, and gentamicin 75.0%. Fungal iolate were Candida pecie (9/313), Apergillu pecie (9/313), and other mold (9/313). Among the endophthalmiti categorie, the mot frequent organim were the following: (1) acute-onet potoperative: epidermidi, 46.9%; (2) delayed-onet potoperative: epidermidi, 22.7%; (3) delayed-onet bleb-aociated: fatidiou gram-negative rod, 20.4%; (4) pottraumatic: epidermidi, 20.8%; (5) endogenou: Apergillu pecie, 20.8%; and (6) micellaneou: mold (other), 36.4%. Concluion In conidering antibiotic treatment of endophthalmiti, it i important to recognize that no ingle antibiotic provided coverage for all of the microbe iolated from eye with endophthalmiti. Combination therapy i recommended a the initial empiric treatment of upected bacterial endophthalmiti. Appropriate hitory and characteritic clinical feature may jutify the ue of initial antifungal agent. Knowledge of the mot frequent cauative organim in variou categorie will help direct appropriate initial therapy.