Surveillance of post-cataract endophthalmitis at a tertiary referral center: a 10-year critical evaluation

• Published in: International journal of retina and vitreous Vol. 7; no. 1; p. 14
• Main Authors: Kato, Juliana Mika, Tanaka, Tatiana, de Oliveira, Luiza Manhezi Shin, de Oliveira, Maura Salaroli, Rossi, Flavia, Goldbaum, Mauro, Pimentel, Sergio Luis Gianotti, de Almeida Junior, João Nóbrega, Yamamoto, Joyce Hisae
• Format: Journal Article
• Language: English
• Published: England BioMed Central 16.02.2021; BMC
• Subjects: Antibiotic resistance; Antibiotics; Automation; Bacteria; Cataract surgery; Cataracts; Drug resistance; Endophthalmitis; Eye surgery; Gram-positive bacteria; Health surveillance; Iodine; Original; Pediatrics; Public health; Staphylococcus infections; Trends; Brazil; Sweden; South Korea; France; Endophthalmitis; Cataract surgery; Antibiotic resistance
• ISSN: 2056-9920; 2056-9920
• DOI: 10.1186/s40942-021-00280-1

Acute post-cataract endophthalmitis (APE) is a rare complication potentially causing irreversible visual loss. A 10-year study of APE was conducted to determine its incidence, microbiological spectra and antibiotic resistance profile of APE-related pathogens at a major tertiary referral center in Brazil. APE cases reported between January 2010 and December 2019 were included. Phacoemulsification and extracapsular cataract techniques were eligible; combined procedures, traumatic and congenital cataract were excluded. Vitreous samples were cultured and antimicrobial resistance was compared for the periods of 2010-2014 and 2015-2019. The results were analyzed with Fisher's exact test. Our sample consisted of 40,491 cataract surgeries and 51 (0.126%) APE cases. Culture was positive in 35 cases (71.4%), of which 31 (88.6%) Gram-positive, 3 (8.6%) Gram-negative, and 1 (2.9%) fungal. The most frequently isolated organism was Staphylococcus epidermidis (n = 17/35, 48.6%), followed by Staphylococcus aureus (n = 4/35, 11.4%). From 2010-2014 to 2015-2019, antimicrobial resistance increased against moxifloxacin (11.1-54.5%, p = 0.07), ciprofloxacin (54.5-72.7%, p = 0.659) and oxacillin (66.7-93.3%, p = 0.13). The observed incidence and microbial spectra were compatible with previous studies. A trend towards growing moxifloxacin and ciprofloxacin resistance was observed. Surveillance remains crucial to prevent treatment failure from antimicrobial resistance.