An Eleven-Year Retrospective Study of Endogenous Bacterial Endophthalmitis

Table 2

Ocular features, microbiological findings, and treatments.

Number	Eye	Type of EBE^※1	Organism	Culture			Antibiotics		Surgery^※3	Initial VA	Outcome; (follow-up in weeks)
				Blood	Vitreous	Other positive cultures	Systemic	Intravitreal^※2
1	OD	Pan	K. pneumoniae	−	+		ASPC	None	Enucleation (7)	CF	NLP (17)
2	OS	PD	S.aureus	+	ND	Psoas (S.aureus)	PAPM/PM, VCM, CLDM, CTRX	CAZ (<1)	—	20/25	20/16 (520)
3	OD	PF (N-L-T)	S.agalactiae, CNS	+	+		IPM/CS, ITCZ	VCM + CAZ^# (1)	Vit + PEA (1)	20/600	20/20 (35)
4^†	OS	PD	MRSA	+	− (AQ−)	Urine (MRSA)	PAPM/BP, VCM	VCM + CAZ^# (1)	Vit + PEA + s/o (1)	CF	20/200 (3)
5^†	OS	PD	S.aureus, S.agalactiae	+	ND		CEZ, ST, MEPM, F-FLCZ, CDTR-PI	None	—	20/600	20/25 (78)
6	OS	PF (Pos)	Nocardia farcinica	+	−^※4		MCFG, F-FLCZ, MEPM, IPM/CS, ST	None	—	20/50
7	OS	Pan	S.equisimilis	+	+ (AQ+)		PCG, CTRX, GM,; TAZ/PIPC	VCM + MEPM (<1)	—	LP	Phthisis (57)
8^†	OD	PD	MRSA	ND	−	IV cannula (MRSA)	CPR, VCM	VCM + CAZ^# (9)	Vit + PEA (37)	LP	Phthisis (2)
9	OD	PF (Pos)	MRSA	+	ND		CAZ, BIPM, CEZ, CTM	None	—	20/20	20/25 (35)
10	OD; OS	PD; PD	S.pneumoniae	+	−; −		CPR, TAZ/PIPC, PIPC, FMOX, CFPN-PI	VCM + CAZ^# (28); VCM + CAZ^# (8 & 15)	Vit + PEA + s/o (30); Vit + PEA (10)	LP; HM	LP (196); HM (196)
11	OD; OS	PF; PF	Unknown	−	ND	Sputum (MRSA)	FOM, CZOP, CTRX, GM, VCM, LZD	None; None	—	20/32; 20/28	20/16 (113); 20/16 (113)
12	OS	Pan	K. pneumoniae	−	+ (AQ+)		CPR, CEZ, IPM/CS.; CTRX	None	Enucleation (9)	LP	NLP (4)
13^†	OD; OS	PF (T); PD	MRSA	+	ND		CFDN, MEPM, MINO, MCFG, F-FLCZ, BIPM, LVFX, TAZ/PIPC, VCM, LZD	None; None	—	ND	Death (3)
14^†	OD; OS	PF (N); PF (N)	MRSA	+	(AQ−); (AQ−)		VCM, TEIC	VCM + CAZ (8 & 15); VCM + CAZ (15)	—	20/500; 20/500	20/250 (14); 20/200 (14)
15	OS	PF (N)	S.agalactiae	+	ND		AZM, IPM/CS, GM	None	—	CF	20/20 (33)
16	OD	PD	Unknown	−	(AQ−)		CZOP	VCM + CAZ (4)	—	HM	HM (15)
17^†	OS	PD	MRSA	+	(AQ−)		VCM, F-FLCZ	VCM (<1 & 2)	—	HM	20/60 (7)
18	OS	PD	Neisseria sp.	S.aureus	+		VCM, MEPM, CEZ,; MCFG, FLCZ	VCM + CAZ^# (22)	Vit (22)	20/25	20/20 (7)
19^†	OD; OS	PF (SupN); Pan	S.aureus	+	+		MINO, DRPM, LZD, CEZ	VCM + CAZ (<1); None	—; Enucleation (23)	20/20; NLP	(67); NLP (67)
20	OS	PF (SupN)	MRSA	−	ND	Leg abscess (MRSA)	ST, CTRX, LZD	None	—	20/20	20/20 (44)
21^†	OD; OS	PF (T); PF (T)	MRSA, E.cloacae	+	ND	IV cannula (MRSA)	CFPM, F-FLCZ, LZD, DAP, RFP, ST	VCM (9); VCM (16)	—	20/100; 20/40	20/20 (39); (39)

Hospital-acquired patient, ^※1site of subretinal abscess in parentheses, ^※2number in parentheses represents days from diagnosis of endophthalmitis, ^※3number in parentheses represents days from onset of ocular symptoms, and ^※4diagnostic vitrectomy; OD, right eye; OS, left eye; EBE, endogenous bacterial endophthalmitis; Pan, panophthalmitis; PD, posterior diffuse; PF, posterior focal: N, nasal; T, temporal; L, lower; Pos, posterior; SupT, superior temporal; SupN, superior nasal; CNS, coagulase-negative Staphylococcus; MRSA, methicillin-resistant Staphylococcus aureus; AQ, aqueous; ND, not done; IV, intravenous; VA, visual acuity; Vit, vitrectomy; PEA, phacoemulsification and aspiration; s/o, silicone oil; NLP, no light perception; CF, counting fingers; LP, light perception; HM, hand motion; cataract and epiretinal membrane; vitreous hemorrhage; cataract; ^#vitrectomy and intravitreal injection; not detected Neisseria sp. from blood culture; TAZ/PIPC, tazobactam/piperacillin; PIPC, piperacillin; PCG, benzyl penicillin; ASPC, aspoxicillin; CTRX, ceftriaxone; CEZ, cefazolin; CPR, cefpirome; CZOP, cefozopran; CDTR-PI, cefditoren pivoxil; CTM, cefotiam; CFDN, cefdinir; CAZ, ceftazidime; CFPM, cefepime; FMOX, flomoxef; CFPN-PI, cefcapene pivoxil; IPM/CS, imipenem/cilastatin; MEPM, meropenem; BIPM, biapenem; PAPM/BP, panipenem/betamipron; DRPM, doripenem; GM, gentamicin; AZM, azithromycin; CLDM, clindamycin; MINO, minocycline; LZD, linezolid; VCM, vancomycin; TEIC, teicoplanin; DAP, daptomycin; LVFX, levofloxacin; RFP, rifampicin; ST, sulfamethoxazole; FOM, fosfomycin; F-FLCZ, fosfluconazole; MCFG, micafungin.