The comparison of clinical outcomes of endophthalmitis from fluoroquinolone-resistant and susceptible bacteria

Abstract

Anita R Shirodkar, Harry W Flynn Jr, Kyle Alliman, Geeta A Lalwani, Chrisfouad Alabiad, Andrew A Moshfeghi, Darlene MillerDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USAPurpose: To identify patients who developed acute-onset endophthalmitis after clear corneal cataract surgery, and to compare treatment outcomes between cases caused by fluoroquinolone susceptible organisms versus fluoroquinolone resistant organisms.Design: Retrospective case series.Methods: Patients who developed endophthalmitis within six weeks of cataract surgery, and were treated between January 1996 and December 2008 at Bascom Palmer Eye Institute in Miami, Florida, were identified retrospectively. Clinical features, organisms cultured, and visual acuity outcomes were evaluated.Results: A total of 97 patients met study criteria, and 37 (38%) demonstrated in vitro fluoroquinolone resistance. All fluoroquinolone resistant endophthalmitis in the study was caused by either Staphylococcus epidermidis (n = 32) or Staphylococcus aureus (n = 5). Presenting clinical features were similar between fluoroquinolone resistant and fluoroquinolone susceptible groups. Final visual acuity was ≥20/40 in 49% of fluoroquinolone-resistant cases and 42% of fluoroquinolonesusceptible cases. All fluoroquinolone-resistant isolates were susceptible to vancomycin.Conclusion: In the current study, approximately one-third of isolates were resistant to fluoroquinolones. There was no significant difference in clinical outcomes in this study, regardless of fluoroquinolone susceptibility.Keywords: endophthalmitis, fluoroquinolones