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Das T, Pandey S, Joseph J, Sheth J, Belenje A, Behera UC, Kapoor A, Pandya R, Dave VP. Antibiotic susceptibility in Endophthalmitis Management Study and intravitreal antibiotic practice trend in India-EMS Report #5. Graefes Arch Clin Exp Ophthalmol 2024; 262:2163-2169. [PMID: 38319381 DOI: 10.1007/s00417-024-06391-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 02/07/2024] Open
Abstract
AIM Analyze antibiotic susceptibility in the Endophthalmitis Management Study (EMS) and compare it with the current intravitreal antibiotic practice trend of members of the Vitreoretinal Society of India (VRSI) practicing in India. METHODS The microbiology work-up of undiluted vitreous included microscopy, culture-susceptibility, polymerase chain reaction (PCR), and next-generation sequencing (NGS). VRSI members were invited to the survey. The EMS conventional culture-susceptibility (PCR and NGS excluded) results were compared vis-a-vis gram-positive cocci (GPC), gram-negative bacilli (GNB), and less commonly used antibiotics with the current recommended intravitreal antibiotics. p < 0.05 was considered significant. RESULTS Culture and positivity (culture + PCR/NGS) positivity was 28.8% and 56.1%, respectively. GPC was most susceptible to cefazolin, linezolid, and vancomycin; GNB was most susceptible to amikacin, ceftazidime, colistin, and imipenem. There was no susceptibility difference between cefazolin and vancomycin (p = 0.999) and between ceftazidime and imipenem (p = 1.0). Colistin was superior to ceftazidime (p = 0.047) against GNB. The GNB resistant to amikacin (n = 14) were equally susceptible to ceftazidime and colistin; resistant to ceftazidime (n = 16) were susceptible to colistin; and resistant to colistin (n = 7) were susceptible to ceftazidime. The preference of VRSI members (n = 231) practicing in India was a vancomycin-ceftazidime combination (82%), vancomycin for GPC (94%), ceftazidime for GNB (61%), and voriconazole for fungi (74%). CONCLUSION In EMS, GPC had good susceptibility to vancomycin; GNB had good susceptibility to ceftazidime and colistin. Given the lower resistance of colistin, a vancomycin-colistin combination could be an alternative empiric treatment in post-cataract endophthalmitis in India.
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Affiliation(s)
- Taraprasad Das
- Anant Bajaj Retina Institute, Srimati Kanuri Santhamma Centre for Vitreoretinal Disease, L V Prasad Eye Institute, Hyderabad, India.
| | - Suchita Pandey
- Jhaveri Microbiology Center, L V Prasad Eye Institute, Hyderabad, India
| | - Joveeta Joseph
- Jhaveri Microbiology Center, L V Prasad Eye Institute, Hyderabad, India
| | - Jay Sheth
- Retina Service, Shantilal Shanghvi Eye Institute, Mumbai, India
| | - Akash Belenje
- Anant Bajaj Retina Institute, Srimati Kanuri Santhamma Centre for Vitreoretinal Disease, L V Prasad Eye Institute, Hyderabad, India
| | - Umesh C Behera
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Bhubaneswar, India
| | - Aditya Kapoor
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Vijayawada, India
| | - Rudvij Pandya
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Vishakhapatnam, India
| | - Vivek Pravin Dave
- Anant Bajaj Retina Institute, Srimati Kanuri Santhamma Centre for Vitreoretinal Disease, L V Prasad Eye Institute, Hyderabad, India
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Das T, Belenje A, Joseph J, Pandey S, Behera U, Dave VP. Evaluating the utility of inflammation score in post-cataract surgery endophthalmitis. Results from a prospective study in India. EMS Report #4. Indian J Ophthalmol 2024; 72:81-86. [PMID: 38131575 PMCID: PMC10841797 DOI: 10.4103/ijo.ijo_997_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 07/07/2023] [Accepted: 08/01/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE To investigate if inflammation score (IS), calculated from the cornea, anterior chamber, iris, and vitreous, indicates endophthalmitis severity. METHODS In a prospective study, consecutive adults with a clinical diagnosis of post-cataract endophthalmitis within 6 weeks of surgery were recruited. Patients were allocated to IS-based primary treatment (IS < 10: intravitreal injection and IS ≥ 10: vitrectomy) and randomized to two intravitreal antibiotics combinations (vancomycin + ceftazidime and vancomycin + imipenem). Undiluted vitreous microbiology work-up included culture susceptibility, polymerase chain reaction, Sanger sequencing, and targeted next-generation sequencing. RESULTS The average age of 175 people was 63.4 ± 10.7 years and included 52.6% small incision cataract surgery and 47.4% phacoemulsification surgery. Severe endophthalmitis (IS ≥ 20), diagnosed in 27.4% of people, had a shorter time to symptoms (average 5.4 vs 8.7 days; P = 0.018), poorer presenting vision (all ≤ hand motion), higher culture positivity (50% vs 30.7%; P = 0.032), and higher Gram-negative bacterial infection (70.8% vs 46.2%; P = 0.042). For IS ≥ 20 discriminant and Gram-negative infection, Spearman's coefficient was 0.7 [P < 0.0001, 95% confidence interval (CI) 0.59-0.82], with an area under the receiver operating characteristic curve of 0.9 (95% CI 0.85-0.94, P < 0.0001), a Youden index J of 0.74, a sensitivity of 87.2%, and a specificity of 87.5%. The final vision of >20/400 and >20/100 was regained in 50.2% and 29.1% of people, respectively. The susceptibility of common Gram-positive cocci and Gram-negative bacilli was the highest for vancomycin (95.0%) and colistin (88.6%), respectively. NGS detected polymicrobial infection in 88.5% of culture-negative endophthalmitis. CONCLUSIONS Higher inflammation scores indicated severe disease and Gram-negative infection in post-cataract endophthalmitis.
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Affiliation(s)
- Taraprasad Das
- Anant Bajaj Retina Institute, Srimati Kanuri Santhama Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Akash Belenje
- Anant Bajaj Retina Institute, Srimati Kanuri Santhama Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Joveeta Joseph
- Jhaveri Microbiology Center, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Suchita Pandey
- Jhaveri Microbiology Center, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Umesh Behera
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Retina Service, Bhubaneswar, Odisha, India
| | - Vivek Pravin Dave
- Anant Bajaj Retina Institute, Srimati Kanuri Santhama Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - on behalf of the EMS working group
- Anant Bajaj Retina Institute, Srimati Kanuri Santhama Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Ramamurthy SR, Joseph J, Dave VP. Clinical settings, management and factors affecting outcomes in multi and extensively-drug resistant Pseudomonas endophthalmitis. Eur J Ophthalmol 2023; 33:1997-2005. [PMID: 36908204 DOI: 10.1177/11206721231163353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
PURPOSE To report the clinical settings, management and factors affecting outcomes in multi-drug resistant (MDR) and extensively-drug resistant (XDR) Pseudomonas endophthalmitis. SETTINGS Retrospective, consecutive, non-comparative interventional case series. Cases of MDR and XDR Pseudomonas endophthalmitis from January 2012 to December 2020 treated at our tertiary eye care center were included. Data collected included clinical data, anatomic and functional outcome, isolated micro-organisms, and culture sensitivity. RESULTS This study included 29 eyes of 29 patients with MDR/XDR Pseudomonas endophthalmitis. Mean age at presentation was 60.27 ± 14.9 years (median 63). Commonest clinical setting was acute post-operative endophthalmitis in 27 cases (93.1%). Concurrent corneal infiltrate was present in 11 eyes (37.9%). Initial intervention in 19 eyes (65.5%) was vitrectomy, 2 of which underwent endoscopic pars plana vitrectomy. Mean number of interventions was 3.34 ± 1.44 (median 4). Mean follow up was 3.25 ± 3.07 months (median 2). Sensitivity to ceftazidime was 48.28%. All isolates were sensitive to colistin. Mean visual acuity at last follow up in logMAR was 2.64 ± 1.48 (median 3.5). Seven eyes (24.13%) were NPL (nil perception of light) at the last follow up. Two eyes (6.9%) underwent evisceration. Nine eyes (31.03%) had a favourable anatomic and functional outcome. Eyes without a corneal infiltrate at presentation were found to have a favourable anatomic and favourable functional outcome (OR 11.91, P < 0.04, CI 1.08 to 130.93). CONCLUSION Corneal involvement at presentation is associated with poorer outcomes in MDR and XDR Pseudomonas endophthalmitis. There is a potential role of higher newer antibiotics especially colistin in the management of these cases.
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Affiliation(s)
- Srishti Raksheeth Ramamurthy
- Anant Bajaj Retina Institute, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India
- Standard Chartered Academy for Eye Care Education, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India
| | - Joveeta Joseph
- Jhaveri Microbiology Center, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India
| | - Vivek Pravin Dave
- Anant Bajaj Retina Institute, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India
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Velez-Montoya R, Monroy-Esquivel L, Ortiz-Guevara R, Quiroz-Mercado H, Fromow-Guerra J. ALTERNATIVE INTRAVITREAL ANTIBIOTICS: A Systematic Review for Consideration in Recalcitrant or Resistant Endophthalmitis. Retina 2023; 43:1433-1447. [PMID: 36893433 DOI: 10.1097/iae.0000000000003773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
PURPOSE To organize, categorize, and create a quick reference guide for the use of intravitreal antibiotic alternatives to the standard combination of vancomycin and ceftazidime for the treatment of endophthalmitis. METHODS A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. The authors searched for all available information regarding intravitreal antibiotics in the last 21 years. Manuscripts were selected according to relevance, level of information, and the available data regarding intravitreal dose, potential adverse effects, bacterial coverage, and relevant pharmacokinetic information. RESULTS The authors included 164 of 1810 manuscripts. The antibiotics were classified according to their class into fluoroquinolones, cephalosporins, glycopeptide and lipopeptide, penicillins and beta-lactams, tetracyclines, and miscellaneous. The authors also included information regarding intravitreal adjuvants for the treatment of endophthalmitis and one ocular antiseptic. CONCLUSION The treatment of infectious endophthalmitis is a therapeutic challenge. The current review summarizes the properties of possible intravitreal antibiotic alternatives that should be considered in cases of suboptimal response to initial treatment.
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Affiliation(s)
- Raul Velez-Montoya
- Retina department, Asociación para Evitar le Ceguera en México IAP, México City, México
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Das T, Belenje A, Pandey S, Behera UC, Joseph J, Dave VP. Endophthalmitis Management Study-A Prospective Randomized Clinical Trial on Postoperative Endophthalmitis Management in India: An Interim Analysis. Endophthalmitis Management Study Report #3. Asia Pac J Ophthalmol (Phila) 2023; 12:437-443. [PMID: 37851560 DOI: 10.1097/apo.0000000000000633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/06/2023] [Indexed: 10/20/2023] Open
Abstract
PURPOSE An interim analysis of the Endophthalmitis Management Study to examine the outcome of inflammation score (IS)-based treatment and antibiotic susceptibility. DESIGN A prospective randomized study. PATIENTS AND METHODS IS was measured on a 0-4 scale from presenting signs in 4 cardinal ocular tissues. The eyes with IS <10 received vitreous tap and intravitreal antibiotics, whereas eyes with IS ≥10 received vitrectomy and intravitreal antibiotics. These eyes were randomized to 2 intravitreal antibiotic combinations: (1) vancomycin and ceftazidime and (2) vancomycin and imipenem. Microbiology workup of undiluted vitreous included microscopy, culture-susceptibility, Sanger, and targeted next-generation sequencing. The clinical and microbiology outcomes were analyzed for advanced (IS = ≥20) and less advanced (IS = <10) endophthalmitis. RESULTS Interim analysis was performed after the Endophthalmitis Management Study recruited 56.85% (248/436) of patients and completed 54.6% (238/436) of microbiology workup. A 90-day follow-up was completed in 90.8% (168/185) of eligible people. In eyes with IS ≥20, the time to symptoms was shorter (5.8 ± 6.7 vs 8.5 ± 9.1 d; P = 0.015), and the need for additional treatment was higher (95.8% vs 53.1%; P = 0.0267). Good final vision was associated with good presenting vision (r = 0.30) and IS-based treatment decisions (r = 0.170). Microbiology positivity was 55.9%. Eyes with IS <10 had a higher Gram-positive cocci (33.9% vs 4.8%; P = 0.013) infection. Gram-positive cocci were most susceptible to vancomycin (95.7%), and Gram-negative bacilli to colistin (95.7%). CONCLUSIONS Considering both IS and presenting vision, rather than only one of them, helps in making appropriate management decisions for acute postoperative endophthalmitis.
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Affiliation(s)
- Taraprasad Das
- Anant Bajaj Retina Institute, Srimati Kanuri Santhamma Centre for Vitreoretinal Disease, LV Prasad Eye Institute, Hyderabad, TS, India
| | - Akash Belenje
- Anant Bajaj Retina Institute, Srimati Kanuri Santhamma Centre for Vitreoretinal Disease, LV Prasad Eye Institute, Hyderabad, TS, India
| | - Suchita Pandey
- Jhaveri Microbiology Center, LV Prasad Eye Institute, Hyderabad, TS, India
| | - Umesh C Behera
- Anant Bajaj Retina Institute, Centre for Vitreoretinal Disease, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Joveeta Joseph
- Jhaveri Microbiology Center, LV Prasad Eye Institute, Hyderabad, TS, India
| | - Vivek Pravin Dave
- Anant Bajaj Retina Institute, Srimati Kanuri Santhamma Centre for Vitreoretinal Disease, LV Prasad Eye Institute, Hyderabad, TS, India
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Ozbek M, Odabasi M, Erdur SK, Senturk F, Ozsutcu M, Aras C. Determination of the retinal toxicity of intravitreal colistin in rabbit eyes. Cutan Ocul Toxicol 2021; 40:300-304. [PMID: 34191665 DOI: 10.1080/15569527.2021.1945617] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To determine the possible adverse effects and safe dose range of intravitreal colistin, an antibiotic, after its intravitreal application. METHODS Twenty eyes of 20 adult male and female New Zealand white rabbits were selected. Various concentrations of colistin were prepared. In each rabbit, 0.1 mL of colistin solution or saline solution was injected intravitreally into the right eye. Electroretinographic recordings were taken before and 2 weeks after injection. Histopathological examination was made using a light microscope following enucleation and fixation procedures. In histopathologic cross-sections, the differences between drug-injected eyes and control eyes were evaluated. RESULTS Electroretinographic examination showed a decrease of 30% as a significant value in the a and b wave amplitudes of the rabbits that injected 400 µg/0.1 ml and higher concentrations. Histological examination revealed histiocytic infiltration, histiocytic vacuoles, inflammation, and retinal degeneration in rabbit eyes given 400 µg/0.1 ml, 800 µg/0.1 ml, and 1.6 mg/0.1 ml concentrations of colistin. CONCLUSION Based on our findings, the safe concentration of colistin is 0.2 mg/0.1 ml. Administration of 0.4 mg/0.1 ml was associated with cataract development, electrophysiological depression, and pathological changes in retinal layers.
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Affiliation(s)
- Merve Ozbek
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Mahmut Odabasi
- Department of Ophthalmology, Medipol University Medical School, Istanbul, Turkey
| | - Sevil Karaman Erdur
- Department of Ophthalmology, Medipol University Medical School, Istanbul, Turkey
| | - Fevzi Senturk
- Department of Ophthalmology, Medipol University Medical School, Istanbul, Turkey
| | - Mustafa Ozsutcu
- Department of Ophthalmology, Medipol University Medical School, Istanbul, Turkey
| | - Cengiz Aras
- Department of Ophthalmology, Medipol University Medical School, Istanbul, Turkey
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Pan U, Jain A, Gubert J, Kumari B, Sindal MD. Antibiotic sensitivity trends of pseudomonas endophthalmitis in a tertiary eye care center in South India: A 12-year retrospective study. Indian J Ophthalmol 2021; 68:627-631. [PMID: 32174583 PMCID: PMC7210830 DOI: 10.4103/ijo.ijo_1145_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Purpose: To assess trends in antibiotic sensitivity of pseudomonas and compare multidrug resistance (MDR) between Pseudomonas endophthalmitis cases presenting in two consecutive 6-year time frames in a tertiary center in South India. Methods: This is a retrospective comparative series of all Pseudomonas endophthalmitis cases treated from June 2004 to May 2016. Microbiological culture results in all endophthalmitis patients were screened for pseudomonas. Positive cases in the initial 6 and final 6 years were compared for sensitivity to antibiotics and the proportion of MDR. MDR was defined as resistance to at least two different classes of antibiotics. Results: Pseudomonas accounted for 74 of 389 endophthalmitis cases (19%), 42 in initial 6 and 32 in final 6 years. Sensitivity to ciprofloxacin, ofloxacin, gatifloxacin, moxifloxacin, and ceftazidime was 85.7%, 82.9%, 76.5%, 76.9%, 88.1% up to 2010 which reduced to 75%, 59.4%, 68.8%, 56.3%, 56.3%, respectively, after 2010, being significant for ofloxacin (P = 0.0349) and ceftazidime (P = 0.0028). Susceptibility to amikacin, gentamicin, and tobramycin changed non-significantly from 83.3%, 43.9%, 47.6% to 71.9%, 61.3%, 61.3%, respectively. Twenty of 74 cases (27%) were MDR with 16.7% in first 6 years versus 40.6% in final 6 years. Postoperative MDR cases rose from 10.3% to 50% (P = 0.0048). Conclusion: This study shows rising resistance of Pseudomonas to fluoroquinolones, amikacin, and ceftazidime in endophthalmitis. MDR also showed an upward trend, particularly in postsurgical cases.
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Affiliation(s)
- Utsab Pan
- Vitreoretina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry; Vitreoretina Services, Susrut Eye Foundation and Research Centre, Berhampore, West Bengal, India
| | - Aarti Jain
- Vitreoretina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry; Vitreoretina Services, Giridhar Eye Institute, Kochi, Kerala, India
| | - Joseph Gubert
- Microbiology Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India
| | - Bibha Kumari
- Vitreoretina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry; Geetasri Retina Institute, Ranchi, Jharkhand, India
| | - Manavi D Sindal
- Vitreoretina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India
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Affiliation(s)
- Taraprasad Das
- Srimati Kanuri Santamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India
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Sato KI. Prevalence and Possible Predictors of Drug-Resistant Pseudomonas aeruginosa in External Ocular Infections: A Single-Center, Retrospective, Cross-Sectional Study. Cureus 2020; 12:e8082. [PMID: 32542137 PMCID: PMC7292697 DOI: 10.7759/cureus.8082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective Ocular infections due to multi-drug-resistant Pseudomonas aeruginosa (MDRP) have been reported in recent years. This study was undertaken to determine the culture-positivity rate of P. aeruginosa and drug resistance among patients with suspected external ocular infections and to predict systemic risk factors for drug resistance in P. aeruginosa. Methods This retrospective, single-center, cross-sectional study involved 781 consecutive patients who provided samples for aerobic culture to test for a suspected external ocular infection. DRP was defined as a strain resistant to one or two of three antibiotics, levofloxacin, gentamicin, and imipenem; MDRP was defined as that which was resistant to all three. Results Among 108 patients in whom gram-negative bacilli were observed, P. aeruginosa was isolated from nine patients, including three DRP-positive cases; no MDRP was isolated. P. aeruginosa was not isolated from those <69 years of age. Among patients in whom gram-negative bacilli were detected, the isolation rate of P. aeruginosa was 0 for patients aged ≤64 and 0.1 for those aged ≥65, indicating a significant difference. For patients with gram-negative bacilli, the DRP-positivity rate was significantly higher for hospitalized patients than outpatients. Thus, in addition to being geriatric, being hospitalized was a risk factor for DRP infection among patients with gram-negative bacilli. All the P. aeruginosa strains isolated were susceptible to colistin. Conclusions Our findings may suggest that once gram-negative bacilli are isolated in an elderly hospitalized patient, possible DRP infection and the topical use of colistin should be taken into consideration even before the results of culture and susceptibility testing are obtained.
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Affiliation(s)
- Ken-Ichi Sato
- Ophthalmology, Nikko Memorial Hospital, Muroran, JPN
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TÜRKEN M, YAZTÜRK Ş, YILMAZ M, YILMAZ BOZOĞLAN M. PAN ANTİBİYOTİK DİRENÇLİ PSEUDOMONAS (P. aeruginosa) VE STENOTROPHOMONAS’LARA (S. maltophilia) KARŞI SON SEÇENEK AJANLARDAN BİRİ OLAN KOLİSTİN (COLİSTİN)’İN IN VİTRO ETKİNLİĞİNİN ARAŞTIRILMASI. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2020. [DOI: 10.17517/ksutfd.536070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Mitra S, Basu S, Rath S, Sahu SK. Colistin resistance in Gram-negative ocular infections: prevalence, clinical outcome and antibiotic susceptibility patterns. Int Ophthalmol 2020; 40:1307-1317. [DOI: 10.1007/s10792-020-01298-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 01/20/2020] [Indexed: 10/25/2022]
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Dogra M, Sharma M, Katoch D, Dogra M. Management of multi drug resistant endogenous Klebsiella pneumoniae endophthalmitis with intravitreal and systemic colistin. Indian J Ophthalmol 2018; 66:596-597. [PMID: 29582834 PMCID: PMC5892076 DOI: 10.4103/ijo.ijo_809_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We report a case of a 35-year-old male with a pancreatic pseudocyst, who developed bilateral endogenous endophthalmitis, 4 days after surgical drainage of the pseudocyst. Bacterial cultures of the pancreatic drain fluid and the vitreous tap showed the growth of Klebsiella pneumoniae. The cultured organism was resistant to all the tested antibiotics except colistin. Intravenous colistin was instituted and three injections of intravitreal colistin were given in the left eye of the patient. Complete resolution of infection was seen and visual acuity of 6/6 was regained in both eyes, which was maintained at 4-month follow-up.
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Affiliation(s)
- Mohit Dogra
- Advanced Eye Centre, PGIMER, Chandigarh, India
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Intravitreal colistin for multidrug resistant acute endophthalmitis following Descemet-stripping endothelial keratoplasty due to Klebsiella pneumoniae. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.jcro.2016.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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14
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Multidrug-Resistant Pseudomonas aeruginosa Keratitis. Ophthalmology 2015; 122:2110-4. [DOI: 10.1016/j.ophtha.2015.06.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 06/02/2015] [Accepted: 06/03/2015] [Indexed: 11/20/2022] Open
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Ozcimen M, Sakarya Y, Sakarya R, Goktas S, Ozcimen S. Comment on: Successful use of intravitreal and systemic colistin in treating multidrug resistant Pseudomonas aeruginosa postoperative endophthalmitis. Indian J Ophthalmol 2015; 62:1174. [PMID: 25579365 PMCID: PMC4313504 DOI: 10.4103/0301-4738.149152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Muammer Ozcimen
- Department of Ophthalmology, Konya Training and Research Hospital, Konya, Turkey
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