Role of Antimicrobial Resistance in Outcomes of Acute Endophthalmitis
Background: This study explores local trends in antimicrobial resistance and its influence on long-term visual outcomes following treatment with broad-spectrum empiric intravitreal antibiotics. Methods: All patients undergoing intraocular sampling for endophthalmitis from Auckland between January 20...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-07-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/12/8/1246 |
| _version_ | 1797585740626919424 |
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| author | Aaron Yap Sharmini Muttaiyah Sarah Welch Rachael L. Niederer |
| author_facet | Aaron Yap Sharmini Muttaiyah Sarah Welch Rachael L. Niederer |
| author_sort | Aaron Yap |
| collection | DOAJ |
| description | Background: This study explores local trends in antimicrobial resistance and its influence on long-term visual outcomes following treatment with broad-spectrum empiric intravitreal antibiotics. Methods: All patients undergoing intraocular sampling for endophthalmitis from Auckland between January 2006–May 2023 were included. The impact of antimicrobial resistance on the final visual outcome was analysed using logistic regression models. Results: 389 cases of endophthalmitis were included, and 207 eyes (53.2%) were culture positive. When tested, all Gram-positive microorganisms were fully susceptible to Vancomycin, and all Gram-negative microorganisms demonstrated full or intermediate susceptibility to Ceftazidime. Resistance to at least one antimicrobial agent was present in 89 culture results (43.0%), and multidrug resistance (resistant to ≥3 antimicrobials) in 23 results (11.1%). No increase in resistance was observed over time. The primary procedure was a tap and inject in 251 eyes (64.5%), and early vitrectomy was performed in 196 eyes (50.3%). Severe vision loss (≤20/200) occurred in 167 eyes (42.9%). Antimicrobial resistance was associated with an increased risk of retinal detachment (OR 2.455 <i>p</i> = 0.048) but not vision loss (<i>p</i> = 0.288). Conclusion: High sensitivity to Vancomycin and Ceftazidime was present in our population, reinforcing their role as first-line empiric treatments. Resistant microorganisms were associated with an increased risk of retinal detachment but no alteration in final visual outcome. |
| first_indexed | 2024-03-11T00:11:18Z |
| format | Article |
| id | doaj.art-32fe54b72f844546aa62f466f4a405c8 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T00:11:18Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-32fe54b72f844546aa62f466f4a405c82023-11-18T23:58:56ZengMDPI AGAntibiotics2079-63822023-07-01128124610.3390/antibiotics12081246Role of Antimicrobial Resistance in Outcomes of Acute EndophthalmitisAaron Yap0Sharmini Muttaiyah1Sarah Welch2Rachael L. Niederer3Department of Ophthalmology, University of Auckland, Auckland 1142, New ZealandDepartment of Microbiology, Te Whatu Ora Te Toka Tumai, Auckland 1023, New ZealandDepartment of Ophthalmology, Te Whatu Ora Te Toka Tumai, Auckland 1051, New ZealandDepartment of Ophthalmology, University of Auckland, Auckland 1142, New ZealandBackground: This study explores local trends in antimicrobial resistance and its influence on long-term visual outcomes following treatment with broad-spectrum empiric intravitreal antibiotics. Methods: All patients undergoing intraocular sampling for endophthalmitis from Auckland between January 2006–May 2023 were included. The impact of antimicrobial resistance on the final visual outcome was analysed using logistic regression models. Results: 389 cases of endophthalmitis were included, and 207 eyes (53.2%) were culture positive. When tested, all Gram-positive microorganisms were fully susceptible to Vancomycin, and all Gram-negative microorganisms demonstrated full or intermediate susceptibility to Ceftazidime. Resistance to at least one antimicrobial agent was present in 89 culture results (43.0%), and multidrug resistance (resistant to ≥3 antimicrobials) in 23 results (11.1%). No increase in resistance was observed over time. The primary procedure was a tap and inject in 251 eyes (64.5%), and early vitrectomy was performed in 196 eyes (50.3%). Severe vision loss (≤20/200) occurred in 167 eyes (42.9%). Antimicrobial resistance was associated with an increased risk of retinal detachment (OR 2.455 <i>p</i> = 0.048) but not vision loss (<i>p</i> = 0.288). Conclusion: High sensitivity to Vancomycin and Ceftazidime was present in our population, reinforcing their role as first-line empiric treatments. Resistant microorganisms were associated with an increased risk of retinal detachment but no alteration in final visual outcome.https://www.mdpi.com/2079-6382/12/8/1246antimicrobial resistancevisual outcomeendophthalmitis |
| spellingShingle | Aaron Yap Sharmini Muttaiyah Sarah Welch Rachael L. Niederer Role of Antimicrobial Resistance in Outcomes of Acute Endophthalmitis Antibiotics antimicrobial resistance visual outcome endophthalmitis |
| title | Role of Antimicrobial Resistance in Outcomes of Acute Endophthalmitis |
| title_full | Role of Antimicrobial Resistance in Outcomes of Acute Endophthalmitis |
| title_fullStr | Role of Antimicrobial Resistance in Outcomes of Acute Endophthalmitis |
| title_full_unstemmed | Role of Antimicrobial Resistance in Outcomes of Acute Endophthalmitis |
| title_short | Role of Antimicrobial Resistance in Outcomes of Acute Endophthalmitis |
| title_sort | role of antimicrobial resistance in outcomes of acute endophthalmitis |
| topic | antimicrobial resistance visual outcome endophthalmitis |
| url | https://www.mdpi.com/2079-6382/12/8/1246 |
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