Stenotrophomonas maltophilia endogenous endophthalmitis: clinical presentation, antibiotic susceptibility, and outcomes

Jay Chhablani,1 Aditya Sudhalkar,1 Animesh Jindal,2 Taraprasad Das,1 Swapna R Motukupally,3 Savitri Sharma,3 Avinash Pathengay,2 Harry W Flynn Jr4 1Srimati Kannuri Santhamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India; 2L V Prasad Eye Ins...

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Autores principales:	Chhablani J, Sudhalkar A, Jindal A, Das T, Motukupally SR, Sharma S, Pathengay A, Flynn HW Jr
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/cd085fea519c41aa938646d940d3ac8a
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spelling	oai:doaj.org-article:cd085fea519c41aa938646d940d3ac8a2021-12-02T02:49:01ZStenotrophomonas maltophilia endogenous endophthalmitis: clinical presentation, antibiotic susceptibility, and outcomes1177-5483https://doaj.org/article/cd085fea519c41aa938646d940d3ac8a2014-08-01T00:00:00Zhttp://www.dovepress.com/stenotrophomonas-maltophilia-endogenous-endophthalmitis-clinical-prese-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483 Jay Chhablani,1 Aditya Sudhalkar,1 Animesh Jindal,2 Taraprasad Das,1 Swapna R Motukupally,3 Savitri Sharma,3 Avinash Pathengay,2 Harry W Flynn Jr4 1Srimati Kannuri Santhamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India; 2L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India; 3Jhaveri Microbiology Centre, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India; 4Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, Miller School of Medicine, Miami, FL, USA Objective: To describe clinical presentation, antibiotic susceptibility, and outcomes in patients with Stenotrophomonas maltophilia endogenous endophthalmitis.Design: Retrospective case series.Participants: Four eyes of four patients with S. maltophilia endogenous endophthalmitis.Methods: Retrospective chart review of culture-positive S. maltophilia endogenous endophthalmitis treated at L V Prasad Eye Institute, Hyderabad, India, between January 2007 and December 2012, was done. Collected information included demographic, clinical, and microbiology data.Results: These four patients with S. maltophilia endogenous endophthalmitis cases accounted for 0.47% (4/836) of total bacterial endophthalmitis cases treated in this period. All patients were from a rural setting and younger than 40 years. Two of the four patients had a history of immune compromise or hospitalization. The visual acuity at presentation was less than 20/320 in all patients. Common presenting features were severe anterior and posterior segment inflammation and hypopyon. All patients underwent vitrectomy with injection of intravitreal antibiotics and dexamethasone. Direct microscopy of the vitreous sample was positive in all cases. All isolates were sensitive to fluoroquinolones and chloramphenicol; sensitivity to aminoglycosides and third-generation cephalosporins was highly variable. The final visual acuity was 20/80 or more in three patients. The time to presentation did not seem to influence the visual or anatomical outcome. Conclusion: S. maltophilia is a rare cause of endogenous endophthalmitis and usually occurs in young and apparently healthy individuals. Clinical presentation is moderate to severe, and recovery is variable. Fourth-generation fluoroquinolones and chloramphenicol were the most sensitive antibiotics against S. maltophilia in this series of patients. Keywords: Stenotrophomonas maltophilia, endogenous endophthalmitis, Pseudomonas maltophilia, Xanthomonas maltophiliaChhablani JSudhalkar AJindal ADas TMotukupally SRSharma SPathengay AFlynn HW JrDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2014, Iss default, Pp 1523-1526 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Chhablani J Sudhalkar A Jindal A Das T Motukupally SR Sharma S Pathengay A Flynn HW Jr Stenotrophomonas maltophilia endogenous endophthalmitis: clinical presentation, antibiotic susceptibility, and outcomes
description	Jay Chhablani,1 Aditya Sudhalkar,1 Animesh Jindal,2 Taraprasad Das,1 Swapna R Motukupally,3 Savitri Sharma,3 Avinash Pathengay,2 Harry W Flynn Jr4 1Srimati Kannuri Santhamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India; 2L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India; 3Jhaveri Microbiology Centre, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India; 4Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, Miller School of Medicine, Miami, FL, USA Objective: To describe clinical presentation, antibiotic susceptibility, and outcomes in patients with Stenotrophomonas maltophilia endogenous endophthalmitis.Design: Retrospective case series.Participants: Four eyes of four patients with S. maltophilia endogenous endophthalmitis.Methods: Retrospective chart review of culture-positive S. maltophilia endogenous endophthalmitis treated at L V Prasad Eye Institute, Hyderabad, India, between January 2007 and December 2012, was done. Collected information included demographic, clinical, and microbiology data.Results: These four patients with S. maltophilia endogenous endophthalmitis cases accounted for 0.47% (4/836) of total bacterial endophthalmitis cases treated in this period. All patients were from a rural setting and younger than 40 years. Two of the four patients had a history of immune compromise or hospitalization. The visual acuity at presentation was less than 20/320 in all patients. Common presenting features were severe anterior and posterior segment inflammation and hypopyon. All patients underwent vitrectomy with injection of intravitreal antibiotics and dexamethasone. Direct microscopy of the vitreous sample was positive in all cases. All isolates were sensitive to fluoroquinolones and chloramphenicol; sensitivity to aminoglycosides and third-generation cephalosporins was highly variable. The final visual acuity was 20/80 or more in three patients. The time to presentation did not seem to influence the visual or anatomical outcome. Conclusion: S. maltophilia is a rare cause of endogenous endophthalmitis and usually occurs in young and apparently healthy individuals. Clinical presentation is moderate to severe, and recovery is variable. Fourth-generation fluoroquinolones and chloramphenicol were the most sensitive antibiotics against S. maltophilia in this series of patients. Keywords: Stenotrophomonas maltophilia, endogenous endophthalmitis, Pseudomonas maltophilia, Xanthomonas maltophilia
format	article
author	Chhablani J Sudhalkar A Jindal A Das T Motukupally SR Sharma S Pathengay A Flynn HW Jr
author_facet	Chhablani J Sudhalkar A Jindal A Das T Motukupally SR Sharma S Pathengay A Flynn HW Jr
author_sort	Chhablani J
title	Stenotrophomonas maltophilia endogenous endophthalmitis: clinical presentation, antibiotic susceptibility, and outcomes
title_short	Stenotrophomonas maltophilia endogenous endophthalmitis: clinical presentation, antibiotic susceptibility, and outcomes
title_full	Stenotrophomonas maltophilia endogenous endophthalmitis: clinical presentation, antibiotic susceptibility, and outcomes
title_fullStr	Stenotrophomonas maltophilia endogenous endophthalmitis: clinical presentation, antibiotic susceptibility, and outcomes
title_full_unstemmed	Stenotrophomonas maltophilia endogenous endophthalmitis: clinical presentation, antibiotic susceptibility, and outcomes
title_sort	stenotrophomonas maltophilia endogenous endophthalmitis: clinical presentation, antibiotic susceptibility, and outcomes
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/cd085fea519c41aa938646d940d3ac8a
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_version_	1718402126259945472

Stenotrophomonas maltophilia endogenous endophthalmitis: clinical presentation, antibiotic susceptibility, and outcomes

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