Postcataract endophthalmitis caused by Enterococcus faecalis

Abstract

Purpose: To investigate the management strategies, susceptibility patterns, and visual outcomes of postcataract Enterococcus faecalis endophthalmitis.

Methods: Retrospective chart review study of 26 eyes of 26 patients with culture-proven E. faecalis endophthalmitis.

Results: In initial treatments, pars plana vitrectomy with intravitreal antibiotics in 15 eyes (58%). Resistance patterns among the isolates were the following: vancomycin in 0 of 26 eyes (0%), ampicillin in 0 of 26 eyes (0%), teicoplanin in 0 of 18 eyes (0%), and high-level gentamicin (minimum inhibitory concentration > 500 mg/L) in 8 of 12 eyes (67%). Presenting visual acuity ranged from counting fingers to no light perception. Final visual acuity was better than 5/200 in 4 of 26 eyes (15%), 5/200 to hand motions in 4 of 26 eyes (15%), and light perception to no light perception in 18 of 26 eyes (69%).

Conclusions: Although all E. faecalis isolates were susceptible to vancomycin, endophthalmitis caused by E. faecalis was usually associated with poor visual prognosis.