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Endophthalmitis caused by Bacillus species.
Am J Ophthalmol. 2008 May; 145(5):883-8.AJ

Abstract

PURPOSE

To investigate clinical settings, management, and visual outcomes of endophthalmitis caused by Bacillus species and to review in vitro effectiveness of antibiotics commonly used against Bacillus species.

DESIGN

Retrospective, consecutive case series.

METHODS

Record review of all patients with endophthalmitis caused by Bacillus species treated at Bascom Palmer Eye Institute between January 1, 1990 and July 1, 2007. Antibiotic sensitivities were conducted on 21 of 22 isolates.

RESULTS

Twenty-two eyes of 22 patients met study inclusion criteria. Median follow-up was 18 months. Clinical settings included open globe injury (18 eyes), endogenous (two eyes), delayed-onset bleb-associated (one eye), and acute-onset postoperative (one eye). Twelve (67%) of 18 patients with open globe injuries had intraocular foreign bodies. Presenting visual acuity (VA) was hand movements or better in 13 (59%) patients. Initial treatment included pars plana vitrectomy and injection of antibiotics in 14 eyes (64%), vitreous tap and injection of antibiotics in seven eyes (32%), and evisceration in one eye (5%). Four (18%) patients received additional doses of intravitreal antibiotics; 16 (73%) underwent secondary surgical procedures. Eight (36%) patients achieved a final VA of 20/400 or better and four (18%) achieved a final VA of 20/60 or better. All patients received intraocular vancomycin and a cephalosporin or aminoglycoside. Systemic antibiotics were used in 18 (82%) patients. Fifteen (68%) isolates were Bacillus cereus. All isolates tested were sensitive to vancomycin, gentamicin, and five fluoroquinolones. Only three of 21 isolates were susceptible to penicillin and cephalosporins.

CONCLUSIONS

Endophthalmitis caused by Bacillus species often results in poor visual outcomes. In vitro antibiotic sensitivities indicate that vancomycin, aminoglycosides, and fluoroquinolones were effective against Bacillus isolates, whereas cephalosporins were relatively ineffective.

Authors+Show Affiliations

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18295182

Citation

Miller, John J., et al. "Endophthalmitis Caused By Bacillus Species." American Journal of Ophthalmology, vol. 145, no. 5, 2008, pp. 883-8.
Miller JJ, Scott IU, Flynn HW, et al. Endophthalmitis caused by Bacillus species. Am J Ophthalmol. 2008;145(5):883-8.
Miller, J. J., Scott, I. U., Flynn, H. W., Smiddy, W. E., Murray, T. G., Berrocal, A., & Miller, D. (2008). Endophthalmitis caused by Bacillus species. American Journal of Ophthalmology, 145(5), 883-8. https://doi.org/10.1016/j.ajo.2007.12.026
Miller JJ, et al. Endophthalmitis Caused By Bacillus Species. Am J Ophthalmol. 2008;145(5):883-8. PubMed PMID: 18295182.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endophthalmitis caused by Bacillus species. AU - Miller,John J, AU - Scott,Ingrid U, AU - Flynn,Harry W,Jr AU - Smiddy,William E, AU - Murray,Timothy G, AU - Berrocal,Audina, AU - Miller,Darlene, Y1 - 2008/03/04/ PY - 2007/10/11/received PY - 2007/12/18/revised PY - 2007/12/19/accepted PY - 2008/2/26/pubmed PY - 2008/5/21/medline PY - 2008/2/26/entrez SP - 883 EP - 8 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 145 IS - 5 N2 - PURPOSE: To investigate clinical settings, management, and visual outcomes of endophthalmitis caused by Bacillus species and to review in vitro effectiveness of antibiotics commonly used against Bacillus species. DESIGN: Retrospective, consecutive case series. METHODS: Record review of all patients with endophthalmitis caused by Bacillus species treated at Bascom Palmer Eye Institute between January 1, 1990 and July 1, 2007. Antibiotic sensitivities were conducted on 21 of 22 isolates. RESULTS: Twenty-two eyes of 22 patients met study inclusion criteria. Median follow-up was 18 months. Clinical settings included open globe injury (18 eyes), endogenous (two eyes), delayed-onset bleb-associated (one eye), and acute-onset postoperative (one eye). Twelve (67%) of 18 patients with open globe injuries had intraocular foreign bodies. Presenting visual acuity (VA) was hand movements or better in 13 (59%) patients. Initial treatment included pars plana vitrectomy and injection of antibiotics in 14 eyes (64%), vitreous tap and injection of antibiotics in seven eyes (32%), and evisceration in one eye (5%). Four (18%) patients received additional doses of intravitreal antibiotics; 16 (73%) underwent secondary surgical procedures. Eight (36%) patients achieved a final VA of 20/400 or better and four (18%) achieved a final VA of 20/60 or better. All patients received intraocular vancomycin and a cephalosporin or aminoglycoside. Systemic antibiotics were used in 18 (82%) patients. Fifteen (68%) isolates were Bacillus cereus. All isolates tested were sensitive to vancomycin, gentamicin, and five fluoroquinolones. Only three of 21 isolates were susceptible to penicillin and cephalosporins. CONCLUSIONS: Endophthalmitis caused by Bacillus species often results in poor visual outcomes. In vitro antibiotic sensitivities indicate that vancomycin, aminoglycosides, and fluoroquinolones were effective against Bacillus isolates, whereas cephalosporins were relatively ineffective. SN - 0002-9394 UR - https://www.unboundmedicine.com/medline/citation/18295182/Endophthalmitis_caused_by_Bacillus_species_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(08)00005-6 DB - PRIME DP - Unbound Medicine ER -