Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results

Jonathan S Chang, Harry W Flynn Jr, Darlene Miller, William E Smiddy Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA Background: Stenotrophomonas maltophilia is a Gram-negative organism known to cause opportunistic infections....

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Autores principales:	Chang JS, Flynn Jr HW, Miller D, Smiddy WE
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/f291867911314293ade5f8161317d6c7
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spelling	oai:doaj.org-article:f291867911314293ade5f8161317d6c72021-12-02T00:28:54ZStenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results1177-54671177-5483https://doaj.org/article/f291867911314293ade5f8161317d6c72013-04-01T00:00:00Zhttp://www.dovepress.com/stenotrophomonas-maltophilia-endophthalmitis-following-cataract-surger-a12826https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Jonathan S Chang, Harry W Flynn Jr, Darlene Miller, William E Smiddy Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA Background: Stenotrophomonas maltophilia is a Gram-negative organism known to cause opportunistic infections. It is a rare source of endophthalmitis, often in the setting of trauma, but has been reported following cataract extraction. The purpose of this study was to evaluate antimicrobial sensitivities, clinical characteristics, and treatment outcomes in patients with endophthalmitis caused by S. maltophilia following cataract extraction. Methods: A retrospective case review of records from January 1, 1990 to June 30, 2010 was performed at the Bascom Palmer Eye Institute. Results: Eight cases of S. maltophilia endophthalmitis were identified following cataract surgery. Initial visual acuity ranged from 20/200 to light perception. Time to diagnosis with cultures was 2–118 days. Patients received either intravitreal tap and inject (n = 5) or pars plana vitrectomy with intravitreal antibiotic injections (n = 3). All patients had vitreous or anterior chamber cultures positive for S. maltophilia. Seven of seven isolates tested were found to be sensitive to ceftazidime. Seven of eight isolates were sensitive to polymyxin B, six of eight isolates were sensitive to amikacin, and five of the seven isolates tested were sensitive to ciprofloxacin. Two of four tested isolates were sensitive to trimethoprim-sulbactam. All eight isolates were resistant to gentamicin and seven of the seven tested isolates were resistant to imipenem. All patients received intravitreal ceftazidime as part of the initial treatment regimen. Final visual acuity ranged from 20/25 to 4/200. Conclusion: S. maltophilia endophthalmitis is a rare source of endophthalmitis following cataract surgery. A case series of eight independent patients is reported, along with antibiotic resistance profiles and clinical outcomes. Isolates showed sensitivity to ceftazidime, amikacin, and polymyxin, with variable sensitivity to other antibiotics, therefore differing from previous reports. Keywords: endophthalmitis, Stenotrophomonas maltophilia, cataractChang JSFlynn Jr HWMiller DSmiddy WEDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2013, Iss default, Pp 771-777 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Chang JS Flynn Jr HW Miller D Smiddy WE Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results
description	Jonathan S Chang, Harry W Flynn Jr, Darlene Miller, William E Smiddy Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA Background: Stenotrophomonas maltophilia is a Gram-negative organism known to cause opportunistic infections. It is a rare source of endophthalmitis, often in the setting of trauma, but has been reported following cataract extraction. The purpose of this study was to evaluate antimicrobial sensitivities, clinical characteristics, and treatment outcomes in patients with endophthalmitis caused by S. maltophilia following cataract extraction. Methods: A retrospective case review of records from January 1, 1990 to June 30, 2010 was performed at the Bascom Palmer Eye Institute. Results: Eight cases of S. maltophilia endophthalmitis were identified following cataract surgery. Initial visual acuity ranged from 20/200 to light perception. Time to diagnosis with cultures was 2–118 days. Patients received either intravitreal tap and inject (n = 5) or pars plana vitrectomy with intravitreal antibiotic injections (n = 3). All patients had vitreous or anterior chamber cultures positive for S. maltophilia. Seven of seven isolates tested were found to be sensitive to ceftazidime. Seven of eight isolates were sensitive to polymyxin B, six of eight isolates were sensitive to amikacin, and five of the seven isolates tested were sensitive to ciprofloxacin. Two of four tested isolates were sensitive to trimethoprim-sulbactam. All eight isolates were resistant to gentamicin and seven of the seven tested isolates were resistant to imipenem. All patients received intravitreal ceftazidime as part of the initial treatment regimen. Final visual acuity ranged from 20/25 to 4/200. Conclusion: S. maltophilia endophthalmitis is a rare source of endophthalmitis following cataract surgery. A case series of eight independent patients is reported, along with antibiotic resistance profiles and clinical outcomes. Isolates showed sensitivity to ceftazidime, amikacin, and polymyxin, with variable sensitivity to other antibiotics, therefore differing from previous reports. Keywords: endophthalmitis, Stenotrophomonas maltophilia, cataract
format	article
author	Chang JS Flynn Jr HW Miller D Smiddy WE
author_facet	Chang JS Flynn Jr HW Miller D Smiddy WE
author_sort	Chang JS
title	Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results
title_short	Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results
title_full	Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results
title_fullStr	Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results
title_full_unstemmed	Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results
title_sort	stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/f291867911314293ade5f8161317d6c7
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Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results

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