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10.1016/j.ajo.2013.12.026

http://scihub22266oqcxt.onion/10.1016/j.ajo.2013.12.026
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C3972252!3972252!24418264
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suck abstract from ncbi


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pmid24418264      Am+J+Ophthalmol 2014 ; 157 (4): 774-780.e1
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  • Endophthalmitis Caused by Streptococcal Species: Clinical Settings, Microbiology, Management, and Outcomes #MMPMID24418264
  • Kuriyan AE; Weiss KD; Flynn HW; Smiddy WE; Berrocal AM; Albini TA; Miller D
  • Am J Ophthalmol 2014[Apr]; 157 (4): 774-780.e1 PMID24418264show ga
  • Purpose: To report the clinical settings, antibiotic susceptibilities, and outcomes of endophthalmitis caused by Streptococcus species. Study Design: Retrospective, observational case series. Methods: Single-center study evaluating all patients with culture-positive endophthalmitis caused by Streptococcus species between January 1, 2000 and December 31, 2011. Results: Study criteria were met by 63 patients. The most common clinical settings were bleb-associated (17, 27%), post-intravitreal injection (16, 25%), and post-cataract surgery (13, 21%). The isolates were S. viridans (47, 71%), S. pneumoniae (13, 21%), and ?-hemolytic Streptococci (5, 8%). Sixty (95%) of 63 isolates were susceptible to vancomycin, 47 (98%) of 48 to ceftriaxone (third generation cephalosporin), and 57 (93%) of 61 to levofloxacin (third generation fluoroquinolone). Between the first and second half of the study period, the minimal inhibitory concentration (MIC) of antibiotics required to inhibit 90% of isolates increased by 1.5-fold for ceftriaxone and 2-fold for levofloxacin, and remained the same for vancomycin. Initial treatment was vitreous tap (49, 78%) or pars plana vitrectomy (14, 22%); all received intravitreal antibiotics. Visual acuity outcomes were variable; best corrected visual acuity (BCVA) was ?20/400 in 16 (25%) patients and <20/400 in 47 (75%) patients. Evisceration/enucleation was performed in 16 (25%) patients. Conclusion: Streptococcus isolates generally had high susceptibility rates to commonly used antibiotics. Higher antibiotic MICs were required to inhibit 90% of isolates in vitro in the second half of the study period compared to the first half. Despite prompt treatment, the majority of patients had poor outcomes.
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