Enterococcus faecalis endophthalmitis: Clinical settings, antibiotic susceptibility, and management outcomes

Kuan Jen Chen*, Chi Chun Lai, Hung Chi Chen, Ying Jiun Chong, Ming Hui Sun, Yen Po Chen, Nan Kai Wang, Yih Shiou Hwang, An Ning Chao, Wei Chi Wu, Ling Yeung, Chi Chin Sun, Laura Liu, Yi Hsing Chen, Hung Da Chou

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

7 Scopus citations

Abstract

Enterococcus faecalis is known to cause severe acute endophthalmitis and often leads to poor visual outcomes in most ophthalmic infections. This retrospective study is to report the clinical settings, antimicrobial susceptibility patterns, and visual outcome of E. faecalis endophthalmitis at a tertiary referral institution in Taoyuan, Taiwan. E. faecalis endophthalmitis was diagnosed in 37 eyes of 37 patients. Post-cataract surgery was the most common cause (n = 27, 73%), followed by bleb-associated (n = 3, 8%), endogenous (n = 2, 5%), corneal ulcer-related (n = 2, 5%), postvitrectomy (n = 1, 3%), post-pterygium excision (n = 1, 3%), and trauma (n = 1, 3%). Visual acuities upon presentation ranged from counting fingers to no light perception. Pars plana vitrectomy with intravitreal antibiotics were performed in 23 eyes (76%) as primary or secondary treatment. All isolates (37/37, 100%) were sensitive to vancomycin, penicillin, ampicillin, and teicoplanin. Six of 22 eyes (27%) were resistant to high-level gentamicin (minimum inhibitory concentration > 500 mg/L). Final visual acuities were better than 20/400 in 11 eyes (30%), 5/200 to hand motions in 4 eyes (11%), and light perception to no light perception in 22 eyes (59%). Three eyes were treated with evisceration. Compared with non-cataract subgroups, the post-cataract subgroup showed a significant difference of better visual prognosis (p = 0.016).

Original languageEnglish
Article number918
JournalMicroorganisms
Volume9
Issue number5
DOIs
StatePublished - 05 2021

Bibliographical note

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

  • Antibiotic susceptibility
  • Endophthalmitis
  • Enterococcus faecalis
  • Pars plana vitrectomy
  • Vitreous tap

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