title: Correlation between clinical data and antibiotic resistance in coagulase-negative Staphylococcus species isolated from 68 patients with acute post-cataract endophthalmitis.
abstract: Coagulase-negative staphylococci (CNS) cause the majority of post-cataract endophthalmitis, which can lead to anatomical and/or functional loss of the eye. This study reports the antibiotic susceptibilities of CNS isolates associated with acute post-cataract endophthalmitis cases and correlates antibiotic resistance with severity and outcome of infection in these patients. Clinical data (initial ocular examination, final prognosis, antibiotic treatment) and the antibiotic susceptibilities of the isolated CNS strains were obtained from 68 patients with post-surgical endophthalmitis recruited during a 7-year period by the FRench Institutional ENDophthalmitis Study (FRIENDS) group. The CNS strains displayed 100% susceptibility to vancomycin, 70% to fluoroquinolones, 83% to fosfomycin, 46% to imipenem and 18% to piperacillin. The most effective antibiotic combinations were fosfomycin plus a fluoroquinolone and imipenem plus a fluoroquinolone, which were considered adequate in 80% and 58% of patients, respectively. Methicillin resistance was significantly associated with older age (p 0.001), diabetes mellitus (p 0.004), absence of fundus visibility (p 0.06), and poor visual prognosis (p 0.03). Resistance to fluoroquinolones was significantly associated with absence of fundus visibility (p 0.05) and diabetes mellitus (p 0.02). This large prospective study demonstrates that methicillin resistance and, to a lesser extent, fluoroquinolone resistance in CNS strains causing postoperative endophthalmitis are both prevalent in France and associated with a poorer visual prognosis. These results emphasize the need for an effective surveillance of this antibiotic resistance and the development of new diagnostic tools for rapid detection for early optimization of antibiotic therapy in endophthalmitis patients.
authors: Department of Ophthalmology, University Hospital, Grenoble, France.
authors: C
authors: C
authors: Chiquet
authors: Laboratoire de Bactériologie-Hygiène Hospitalière, Institut de Biologie et de Pathologie, CHU de Grenoble, France.
authors: M
authors: M
authors: Maurin
authors: Department of Ophthalmology, University Hospital, Grenoble, France.
authors: J
authors: J
authors: Altayrac
authors: Department of Ophthalmology, University Hospital, Grenoble, France.
authors: F
authors: F
authors: Aptel
authors: Laboratoire de Bactériologie-Hygiène Hospitalière, Institut de Biologie et de Pathologie, CHU de Grenoble, France.
authors: S
authors: S
authors: Boisset
authors: Laboratoire de Bactériologie, CBPE, Hospices Civils de Lyon, Lyon, France; University Hospital (E. Herriot), Lyon, Université Claude Bernard Lyon 1, France.
authors: F
authors: F
authors: Vandenesch
authors: University Hospital (E. Herriot), Lyon, Université Claude Bernard Lyon 1, France.
authors: P L
authors: PL
authors: Cornut
authors: Department of Ophthalmology, University Hospital, Grenoble, France.
authors: J P
authors: JP
authors: Romanet
authors: Department of Ophthalmology, University Hospital of St-Etienne, Saint-Etienne, France; Laboratory Biology, Engineering and Imaging of Corneal Graft, Jean Monnet University, Saint-Etienne, France.
authors: P
authors: P
authors: Gain
authors: Department of Microbiology, University Hospital, Saint-Etienne, France; GIMAP EA 3064 (Groupe immunité des muqueuses et agents pathogènes), University of Saint-Etienne, Lyon, France. Electronic address: anne.carricajo@chu-st-etienne.fr.
authors: A
authors: A
authors: Carricajo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002387:Cataract Extraction / Q000009:adverse effects; D003030:Coagulase / Q000172:deficiency; D024881:Drug Resistance, Bacterial; D009877:Endophthalmitis / Q000382:microbiology* / Q000473:pathology; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000382:microbiology* / Q000473:pathology; D013210:Staphylococcus / Q000187:drug effects* / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003030:Coagulase
keywords: Antibiotic resistance; antibiotic susceptibility; endophthalmitis; visual prognosis