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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.

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Acknowledgements

We thank The Hyderabad Eye Research Foundation, Hyderabad.

Funding

This work was supported by a grant from the DST-SERB to Dr Joveeta Joseph (File Number: EMR/2016/002259) India.

Author information

Affiliations

  1. Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Hyderabad, India

    • Joveeta Joseph
    • , Bhavani Sontam
    • , Sai Jeevana Madhuri Guda
    • , Jaishree Gandhi
    •  & Savitri Sharma
  2. Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L. V. Prasad Eye Institute, Hyderabad, India

    • Mudit Tyagi
    • , Vivek Pravin Dave
    •  & Taraprasad Das

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Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Joveeta Joseph.

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DOI

https://doi.org/10.1038/s41433-019-0380-8