Título

MICROBIAL ISOLATES AND ANTIBIOTIC RESISTANCE TRENDS IN ENDOPHTHALMITIS FOLLOWING CATARACT SURGERY

Objetivo

To review the microbiological spectrum and antibiotic susceptibility of pathogens responsible for culture-positive endophthalmitis following cataract surgery and to investigate possible trends during 2010-2013 and 2014-2018 periods.

Método

Retrospective study of all cases of endophthalmitis post-cataract surgery performed in a single tertiary health center in Brazil between 2010 and 2018. Identification and susceptibility testing was performed by an automated broth microdilution method (bioMerieux Vitek 2, Hazelwood, MO, USA). Breakpoints were those defined by the CLSI.

Resultado

From a total of 36874 cataract surgeries performed in the last 9 years, 49 cases of endophthalmitis were identified (incidence 0.13% per year). 29 had culture-positive results (60,4%). The most prevalent gram-positive isolated were Staphylococcus epidermidis (48%) and Staphylococcus aureus (10%), followed by Staphylococcus lugdunensis (7%) and Staphylococcus viridans (7%). Gram-negative isolates counted for 17%. 3% of the culture-positive were fungi. Table 1 shows a detailed overview of the isolates. We found a trend toward increasing resistance to moxifloxacin, ciprofloxacin and oxacillin. Susceptibility pattern in given on Table 2. Moxifloxacin-resistance strains increased from 11% to 55%, and Ciprofloxacin-resistance strains increased from 40% to 73%.

Conclusão

Microbial spectrum is similar to previous studies and empirical therapy with vancomycin and ceftazidime remains appropriate. A trend toward increasing resistance against widely-used moxifloxacin and ciprofloxacin was observed. As antibiotic resistance can be the cause of treatment failures and may result in vision loss and blindness, surveillance remains crucial.