Endophthalmitis caused by Stenotrophomonas maltophilia.
OBJECTIVE
The authors investigate clinical settings, antibiotic susceptibility and resistance patterns, and visual outcomes associated with endophthalmitis caused by Stenotrophomonas maltophilia.


METHODS
Records of six patients with S. maltophilia endophthalmitis between January 1, 1998, and December 31, 2007, were reviewed.


RESULTS
Clinical settings included post-trauma (2 eyes), post-cataract extraction (2 eyes), post-keratoplasty with keratitis (1 eye), and post-vitreous lavage (1 eye). Presenting visual acuity ranged from counting fingers to no light perception. Final visual acuity ranged from 10/20 to no light perception. Initial treatment included pars plana vitrectomy in 4 eyes and tap in 2 eyes. Most isolates were susceptible to fluoroquinolones (ciprofloxacin, levofloxacin, or moxifloxacin) and sulfamethoxazole-trimethoprim; however, they were resistant to ceftazidime and aminoglycosides.


CONCLUSIONS
S. maltophilia is an uncommon causative agent of endophthalmitis and is resistant to commonly used antibiotics, such as ceftazidime and aminoglycosides. Based on in vitro antibiotic susceptibility testing, sulfamethoxazole-trimethoprim and new-generation fluoroquinolones may be preferable in the treatment of endophthalmitis caused by S. maltophilia.
Chen
Kuan-Jen
KJ
Department of Ophthalmology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan, Taiwan. cgr999chiayi@yahoo.com.tw
Wang
Nan-Kai
NK
Sun
Ming-Hui
MH
Chen
Tun-Lu
TL
Lai
Chi-Chun
CC
Wu
Wei-Chi
WC
Tan
Hsin-Yuan
HY
D000328:Adult; D000368:Aged; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015807:Eye Injuries, Penetrating / Q000382:microbiology; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D018918:Phacoemulsification; D020615:Stenotrophomonas maltophilia / Q000187:drug effects / Q000302:isolation & purification*; D013530:Surgical Wound Infection / Q000382:microbiology; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology / Q000627:therapeutic use; D014792:Visual Acuity / Q000502:physiology; D014949:Wounds, Nonpenetrating / Q000382:microbiology
D024841:Fluoroquinolones; D015662:Trimethoprim, Sulfamethoxazole Drug Combination