title: Bacterial endophthalmitis: 10-year review of the culture and sensitivity patterns of bacterial isolates.
abstract: OBJECTIVE
  To examine the spectrum and sensitivity patterns of bacterial isolates derived from all culture-positive aqueous and vitreous samples submitted for culture and sensitivity analysis at our institution over a 10-year period.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A total of 368 culture-positive aqueous and vitreous samples from 265 patients were reviewed.
  
  
  METHODS
  Over a decade extending from January 2000 through December 2009, all culture-positive aqueous and vitreous specimens at our institution were identified. Isolated bacterial pathogens and their in vitro antibiotic sensitivities were analyzed.
  
  
  RESULTS
  Approximately 86.4% of patients had positive cultures for either staphylococci (Staphylococcus aureus and coagulase-negative staphylococci [CNS]) or streptococci. Gram-negative bacteria were isolated in only 9.8% of patients. From 2000 to 2004, 81.2% and 55.9% of CNS isolates were sensitive to ciprofloxacin and cefazolin, respectively, compared with 41.2% and 23.5% of isolates in the last 5 years. Over the study period, ceftazidime retained 100% efficacy against the gram-negative isolates tested. Vancomycin was 99.6% effective against the gram-positive isolates tested.
  
  
  CONCLUSIONS
  The microbiology of pathogens in endophthalmitis is evolving, with an increase in streptococcal isolates and a decrease in CNS. The apparent lack of efficacy of conventionally used antibiotics and the emergence of increasingly resistant strains of bacteria may have significant implications in the management of bacterial endophthalmitis.
authors.affiliation: Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont.,. Electronic address: david.assaad@utoronto.ca.
authors.forename: David
authors.initials: D
authors.lastname: Assaad
authors.affiliation: Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont..
authors.forename: David
authors.initials: D
authors.lastname: Wong
authors.affiliation: Department of Ophthalmology, McGill University, Montreal, Que..
authors.forename: Mikel
authors.initials: M
authors.lastname: Mikhail
authors.affiliation: Department of Pharmacy, University of Toronto, Ontario, Canada.
authors.forename: Sherri
authors.initials: S
authors.lastname: Tawfik
authors.affiliation: Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont..
authors.forename: Filiberto
authors.initials: F
authors.lastname: Altomare
authors.affiliation: Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont..
authors.forename: Alan
authors.initials: A
authors.lastname: Berger
authors.affiliation: Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont..
authors.forename: David
authors.initials: D
authors.lastname: Chow
authors.affiliation: Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont..
authors.forename: Louis
authors.initials: L
authors.lastname: Giavedoni
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001082:Aqueous Humor / Q000382:microbiology*; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D001431:Bacteriological Techniques; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D015169:Colony Count, Microbial; D009877:Endophthalmitis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D014822:Vitreous Body / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents