Original articleStaphylococcus aureus Endophthalmitis: Antibiotic Susceptibilities, Methicillin Resistance, and Clinical Outcomes
Section snippets
Methods
A computer search of the Bascom Palmer Eye Institute Microbiology Department data base and corresponding medical records identified 32 cases of patients with S. aureus endophthalmitis between January 1, 1995, and January 1, 2008.
Treatments consisted of either tap and inject, that is, aspiration of a vitreous specimen with subsequent injection of antibiotics (vancomycin 1.0 mg and ceftazidime 2.25 mg) or pars plana vitrectomy with subsequent injection of the same antibiotics. Treatment was at
Results
Thirty-two cases of endophthalmitis resulting from S. aureus were identified, including 13 (41%) caused by MRSA and 19 (59%) caused by MSSA. Men and women were distributed equally in both the MRSA and the MSSA group (7 men and 6 women in the MRSA group, 9 men and 10 women in the MSSA group). Also, there was no difference in age between the 2 groups, with a mean age of 66 years in the MRSA group and of 67 years in the MSSA group.
Overall, most endophthalmitis cases caused by S. aureus (18 of 32
Discussion
The current study of 32 patients represents the largest reported clinical case series of S. aureus endophthalmitis (Table 3). In the EVS reports of acute-onset endophthalmitis associated with cataract or secondary intraocular lens implantation, S. aureus was the second most common organism after coagulase-negative staphylococci. In the 30 EVS patients with S. aureus, less than 20/100 vision was found in half of the patients.15
Over the current study period from 1995 through 2008, MRSA accounted
James C. Major, Jr. received his undergraduate degree in Biology from Emory University and Masters and Doctor of Philosophy in Biology at The University of Texas at Austin. Thereafter, he received his medical degree from Baylor College of Medicine. Dr. Major completed his ophthalmology residency, vitreoretinal fellowship, and Chief Residency at the Bascom Palmer Eye Institute in Miami. He served on the faculty at three institutions. He currently is practicing with Retina Consultants of Houston.
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James C. Major, Jr. received his undergraduate degree in Biology from Emory University and Masters and Doctor of Philosophy in Biology at The University of Texas at Austin. Thereafter, he received his medical degree from Baylor College of Medicine. Dr. Major completed his ophthalmology residency, vitreoretinal fellowship, and Chief Residency at the Bascom Palmer Eye Institute in Miami. He served on the faculty at three institutions. He currently is practicing with Retina Consultants of Houston.