Trends in microbiological spectrum of endophthalmitis at a single tertiary care ophthalmic hospital in India: a review of 25 years.

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.

• Authors: Joveeta Joseph, Bhavani Sontam, Sai Jeevana Madhuri Guda, Jaishree Gandhi, Savitri Sharma, Mudit Tyagi, Vivek Pravin Dave, Taraprasad Das
• Journal: Eye (London, England) (Eye (Lond)) Vol. 33 Issue 7 Pg. 1090-1095 (07 2019) ISSN: 1476-5454 [Electronic] England
• PMID: 30792523 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Bacteria (isolation & purification)
• Endophthalmitis (epidemiology, microbiology)
• Eye Infections, Bacterial (epidemiology, microbiology)
• Eye Infections, Fungal (epidemiology, microbiology)
• Female
• Follow-Up Studies
• Forecasting
• Fungi (isolation & purification)
• Humans
• India (epidemiology)
• Male
• Microbial Sensitivity Tests
• Middle Aged
• Prevalence
• Retrospective Studies
• Tertiary Care Centers (statistics & numerical data)
• Vitreous Body (microbiology)