title: ENDOPHTHALMITIS CAUSED BY PSEUDOMONAS AERUGINOSA: Clinical Features, Antibiotic Susceptibilities, and Treatment Outcomes.
abstract: OBJECTIVE
  To report the clinical features, antibiotic susceptibilities, and visual outcomes associated with endophthalmitis caused by Pseudomonas aeruginosa.
  
  
  METHODS
  A consecutive case series. Microbiology database records were retrospectively reviewed for all patients with endophthalmitis caused by P. aeruginosa from January 1, 2002, to December 31, 2012, at a large university referral center. The corresponding clinical records were then reviewed to evaluate the endophthalmitis clinical features and treatment outcomes.
  
  
  RESULTS
  In the 12 patients identified, clinical settings included postcataract surgery (n = 4), postpenetrating keratoplasty (n = 3), endogenous source (n = 2), post-pars plana vitrectomy (n = 1), trabeculectomy bleb-associated setting (n = 1), and glaucoma drainage implant-associated setting (n = 1). All patients presented with hypopyon. Presenting visual acuity was hand motions or worse in all cases. All isolates were susceptible to ceftazidime and levofloxacin. When comparing isolates in this study with isolates from a previous study (1987 to 2001), the minimal inhibitory concentration required to inhibit 90% of isolates (MIC 90, in micrograms per milliliter) remained the same for ceftazidime (8), ciprofloxacin (0.5), imipenem (4), tobramycin (0.5), and amikacin (4). Initial treatment strategies were vitreous tap and injection (n = 9) and pars plana vitrectomy with intravitreal antibiotics (n = 3). Final visual acuity was light perception or worse in 11 of the 12 patients (92%). Five patients underwent enucleation (42%).
  
  
  CONCLUSIONS
  All isolates were susceptible to ceftazidime and levofloxacin, and all MIC 90s for isolates in the current period compared with isolates from 1987 to 2001 remained identical. Despite early and appropriate treatment, outcomes were generally poor with a high rate of enucleation.
authors: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors: Jayanth
authors: J
authors: Sridhar
authors: Ajay E
authors: AE
authors: Kuriyan
authors: Harry W
authors: HW
authors: Flynn
authors: Darlene
authors: D
authors: Miller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002442:Ceftazidime / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D007223:Infant; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011183:Postoperative Complications; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification*; D014640:Vancomycin / Q000627:therapeutic use; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D002442:Ceftazidime