Postcataract endophthalmitis caused by Enterococcus faecalis.
OBJECTIVE
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.
Chen
Kuan-Jen
KJ
Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. cgr999chiayi@yahoo.com.tw
Lai
Chi-Chun
CC
Sun
Ming-Hui
MH
Chen
Tun-Lu
TL
Yang
Ko-Jen
KJ
Kuo
Ya-Hui
YH
Chao
An-Ning
AN
Wu
Wei-Chi
WC
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002387:Cataract Extraction / Q000009:adverse effects*; D024881:Drug Resistance, Bacterial; D009877:Endophthalmitis / Q000382:microbiology* / Q000503:physiopathology / Q000628:therapy; D013293:Enterococcus faecalis; D015818:Eye Infections, Bacterial / Q000209:etiology* / Q000628:therapy; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007267:Injections; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods; D014822:Vitreous Body
D000900:Anti-Bacterial Agents; D014640:Vancomycin