[Culture proven bacterial endophthalmitis: a 6-year review].
OBJECTIVE
To assess the distribution of microorganisms isolated from patients with bacterial endophthalmitis and their antimicrobial susceptibility.


METHODS
Retrospective analysis of medical and microbiological records of patients with suspected diagnosis of endophthalmitis and bacterial culture-proven at the Department of Ophthalmology, UNIFESP, between January 1 2000 and December 31 2005.


RESULTS
153 (33.9%) of 451 patients showed positive bacterial culture. A total of 155 microorganisms were isolated, 79.35% were gram-positive and 20.65% gram-negative. Staphylococcus (CoNS) (41.94%) were the most frequently isolated. The antimicrobial susceptibility for gram-negative microorganisms was as follows: amikacin 87.10%, tobramycin 80.65%, ciprofloxacin 96.67%, levofloxacin, gatifloxacin and moxifloxacin 100%, ceftazidime 85.0%, and gentamicin 80.65%. Vancomycin sensitivity among gram-positive microorganisms was 100%. S. aureus and CoNS showed 83.33% of susceptibility to oxacillin, 89.61% to ciprofloxacin and 100% to gatifloxacin and moxifloxacin. The main acquisition mechanism was postoperative (60.65%).


CONCLUSIONS
We detected a low sensitivity of vitreous/aqueous culture for the etiologic diagnosis of endophthalmitis. The empiric antimicrobial therapy or prophylaxis should be active against gram-positive bacteria, particularly staphylococci. Surveillance studies of bacterial resistance are important for a better utilization of antimicrobials in this clinical setting.
Bispo
Paulo José Martins
PJ
Departamento de Medicina, Laboratório Especial de Microbiologia Clínica, Universidade Federal de São Paulo, São Paulo, Brasil.
Melo
Gustavo Barreto de
GB
d'Azevedo
Pedro Alves
PA
Höfling-Lima
Ana Luisa
AL
Yu
Maria Cecília Zorat
MC
Pignatari
Antonio Carlos Campos
AC
D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D009877:Endophthalmitis / Q000188:drug therapy / Q000382:microbiology*; D006090:Gram-Negative Bacteria / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents