title: Pathogens and antibiotic sensitivities in endophthalmitis.
abstract: BACKGROUND
  Antibiotic prophylaxis in cataract surgery is intended to minimize endophthalmitis. We describe pathogenic organisms, antibiotic sensitivities and antibiotic prophylaxis in culture-proven endophthalmitis cases.
  
  
  METHODS
  Retrospective consecutive case series and community-based setting were used.
  
  
  METHODS
  Two hundred fifteen cases of endophthalmitis after cataract surgery performed during 2007-2012 in Kaiser Permanente, California.
  
  
  METHODS
  Descriptive analysis of isolated organisms and antibiotic sensitivities in relation to antibiotic prophylaxis in culture-proven endophthalmitis cases.
  
  
  RESULTS
  The majority of culture-confirmed organisms (n = 83) were Gram positive (96%), most notably coagulase-negative Staphylococci (n = 34, 52%), of which all that underwent testing were sensitive to vancomycin (n = 32). Among 19 cases that had received only topical antibiotic prophylaxis, seven (37%) were resistant to the antibiotic given: 50% of cases (5 of 10 isolates) that had received ofloxacin were resistant to this antibiotic, 40% (2 of 5 isolates) that had received gatifloxacin were resistant. In contrast, 100% of cases (n = 4) that had received aminoglycosides were susceptible. Few culture-confirmed cases occurred in patients who received intracameral antibiotic (n = 4).
  
  
  CONCLUSIONS
  In cases where fluoroquinolones were administered as antibiotic prophylaxis, isolates demonstrated a degree of bacterial resistance. The majority of endophthalmitis cases isolated occured following topical antibiotic prophylaxis only and were attributed to Gram-positive organisms, while few occurred in association with intracameral antibiotic.
authors.affiliation: Department of Ophthalmology, California Pacific Medical Center, San Francisco, California, USA.
authors.forename: Geraldine R
authors.initials: GR
authors.lastname: Slean
authors.affiliation: Departments of Ophthalmology and Quality, Kaiser Permanente, Walnut Creek, California, USA.
authors.forename: Neal H
authors.initials: NH
authors.lastname: Shorstein
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
authors.forename: Liyan
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Ophthalmology, Kaiser Permanente, Pasadena, California, USA.
authors.forename: John F
authors.initials: JF
authors.lastname: Paschal
authors.affiliation: Division of Infectious Diseases, Department of Ophthalmology, Oregon Health and Sciences University, Portland, Oregon, USA.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Winthrop
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Herrinton
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D002387:Cataract Extraction / Q000009:adverse effects*; D009877:Endophthalmitis / Q000188:drug therapy / Q000382:microbiology* / Q000517:prevention & control; D015818:Eye Infections, Bacterial / Q000382:microbiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D011379:Prognosis; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000382:microbiology* / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotic; cataract surgery; endophthalmitis; sensitivity