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. 2020 Apr 29:2020:5053923.
doi: 10.1155/2020/5053923. eCollection 2020.

Microbiological Isolates and Antibiotic Susceptibilities in Cases of Posttraumatic Endophthalmitis: A 15-Year Review

Chunhong Liu  1   2 , Jian Ji  1 , Zhujian Wang  1 , Huiwen Chen  1 , Wenjun Cao  1   2 , Xinghuai Sun  2
Affiliations

Microbiological Isolates and Antibiotic Susceptibilities in Cases of Posttraumatic Endophthalmitis: A 15-Year Review

Chunhong Liu et al. J Ophthalmol. .

Abstract

Purpose: The objective of this study was to evaluate the microbiological spectrum and antibiotic susceptibilities of isolates in posttraumatic endophthalmitis over a 15-year period.

Methods: A retrospective study of 3,163 posttraumatic endophthalmitis cases was conducted between July 2004 and July 2019. The outcome measures included the microbiological spectrum and antibiotic susceptibilities. Chi-squared tests were conducted to detect trends in changes in antibiotic sensitivity over the 15-year period. P values of <0.05 were considered statistically significant.

Results: Of the 3,163 cases of posttraumatic endophthalmitis, 1,003 culture-positive isolates were identified. Among these, there were 848 (84.5%) Gram-positive isolates, 109 (10.9%) Gram-negative isolates, and 46 (4.6%) fungal isolates. The most common isolates were Staphylococcal species. There was a significant increase in the percentage of fungal isolates over the 15-year period (P=0.02). Gram-positive organisms showed the greatest level of susceptibility to vancomycin (99.6%). The susceptibilities of the 109 Gram-negative isolated organisms were as follows: levofloxacin (95.8%), meropenem (95.7%), ciprofloxacin (93.5%), tobramycin (90.8%), imipenem (88.9%), trimethoprim-sulfamethoxazole (TMP-SMX) (87.7%), ertapenem (80%), and ceftazidime (79.1%). The susceptibility of Gram-positive organisms to several antibiotics, including levofloxacin (P=0.004), ciprofloxacin (P < 0.001), and chloramphenicol (P=0.001) decreased over time, whereas the susceptibility to TMP-SMX increased over time (P < 0.001). The susceptibility of Gram-negative bacilli to ceftazidime decreased over time (P=0.03).

Conclusions: Over the 15-year study period, most isolates were Gram-positive cocci, especially coagulase-negative staphylococci (CNS). Vancomycin seemed to be the most effective antibiotic for Gram-positive bacteria. Gram-negative bacteria appeared to be most susceptible to fluoroquinolones. A number of antibiotics showed an increasing trend of microbial resistance.

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Conflict of interest statement

The authors declare there are no conflicts of interest.

Figures

Figure 1
Figure 1
Time trends of different isolated organisms from 2004 to 2019. 1, July 2004 to June 2007; 2, July 2007 to June 2010; 3, July 2010 to June 2013; 4, July 2013 to June 2016; 5, July 2016 to July 2019.
Figure 2
Figure 2
Time trends of bacterial susceptibilities. 1, July 2004 to June 2007; 2, July 2007 to June 2010; 3, July 2010 to June 2013; 4, July 2013 to June 2016; 5, July 2016 to July 2019. Susceptibility testing was unavailable for levofloxacin from July 2004 to July 2007. (a) Ciprofloxacin. (b) Levofloxacin. (c) Tobramycin. (d) TMP-SMX.
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