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  • Title: Trends in microbiological spectrum of endophthalmitis at a single tertiary care ophthalmic hospital in India: a review of 25 years.
    Author: Joseph J, Sontam B, Guda SJM, Gandhi J, Sharma S, Tyagi M, Dave VP, Das T.
    Journal: Eye (Lond); 2019 Jul; 33(7):1090-1095. PubMed ID: 30792523.
    Abstract:
    PURPOSE: To determine trends in the microbial spectrum of endophthalmitis over the past 25 years and to review its antibiotic susceptibility patterns over the last 10 years. METHODS: Microbiology records of culture-positive endophthalmitis cases from 1991 to 2015 were reviewed. Additionally, data between 2005 and 2015 was also analyzed for trends in antibiotic susceptibility. RESULTS: Of the total of 9278 patients, 3319 (35.7%) were culture positive and included bacteria (2840/3319, 85.56%), fungi (387/3319, 11.66%), and mixed cultures (92/3319, 2.7%). Gram-positive bacteria accounted for 67.68% (1922/2840) of the total bacteria seen, with the most prevalent pathogen being Streptococcus pneumoniae and Staphylococcus epidermidis. Among the gram-negative organisms Pseudomonas aeruginosa was the most prevalent while. Aspergillus flavus was the most common fungus isolated and Candida sp. accounted for 6.9% of the total fungi isolated. There was no significant change in the trends of bacteria isolated during the study period. Overall susceptibility patterns showed that gram-positive bacteria were most susceptible to vancomycin (96%) and fluoroquinolones (89%). The resistance to ceftazidime increased from 31% in 2005 to 62% in 2015 (P = 0.006) and amikacin decreased from 36% in 2005 to 33% in 2015 (P = 0.782). Although a significant trend (P < 0.001) toward increasing microbial resistance against cephalosporins and fluoroquinolones was observed, decreasing microbial resistance against glycopeptides and aminoglycosides was also detected. CONCLUSION: The spectrum of pathogens causing endophthalmitis at our institute remained similar over the study period. These findings impact the empiric treatment and choice of antibiotics in patients with endophthalmitis.
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