Microbiological isolates and antibiotic sensitivities in culture-proven endophthalmitis: a 15-year review

Abstract

Background: To describe the microbiological spectrum and antibiotic sensitivities of organisms causing culture-proven endophthalmitis in Queensland, Australia, and to compare results with similar studies from other parts of Australia and other countries.

Methods: A retrospective, multicentre, non-comparative, consecutive case series. Public hospital microbiology records from culture-positive endophthalmitis cases were reviewed over 15 years from June 1998 to June 2013. Outcome measures were type of endophthalmitis, vitreous isolates cultured and antibiotic sensitivities.

Results: 205 cases of culture-proven endophthalmitis were identified with a total of 229 isolates cultured. The most common organisms isolated were Staphylococcus epidermidis in 23.1%, Coagulase-negative Staphylococcus in 12.7%, Streptococcus viridans group in 10.0%, Candida species in 6.1%, fungal mold species in 5.7%. For gram-positive organisms, sensitivities were vancomycin 100%, cephazolin 79% and penicillin 47%. For gram-negative organisms, sensitivities were ceftazidime 100%, amikacin 100%, ciprofloxacin 100% and gentamicin 95.5%. For fungal isolates, sensitivities were voriconazole 93%, ketoconazole 89%, caspofungin 70% and amphotericin B 58%.

Conclusions: The microbiological spectrum and antibiotic sensitivities of endophthalmitis cases in Queensland, Australia, is similar to the spectrum of organisms causing endophthalmitis in other parts of Australia, North America and Europe. Empirical intravitreal vancomycin, ceftazidime and voriconazole are the most appropriate empirical antibiotics for suspected infective endophthalmitis.

Keywords: Infection.