Table 2.
Ocular features, microbiological findings, and treatments.
| Number | Eye | Type of EBE※1 | Organism | Culture | Antibiotics | Surgery※3 | Initial VA | Outcome (follow-up in weeks) |
|||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Blood | Vitreous | Other positive cultures | Systemic | Intravitreal※2 | |||||||
| 1 | OD | Pan | K. pneumoniae | − | + | ASPC | None | Enucleation (7) | CF | NLP (17) | |
| 2 | OS | PD | S.aureus | + | ND | Psoas (S.aureus) | PAPM/PM, VCM, CLDM, CTRX | CAZ (<1) | — | 20/25 | 20/16 (520) |
| 3 | OD | PF (N-L-T) | S.agalactiae, CNS | + | + | IPM/CS, ITCZ | VCM + CAZ# (1) | Vit + PEA (1) | 20/600 | 20/20 (35) | |
| 4† | OS | PD | MRSA | + | − (AQ−) | Urine (MRSA) | PAPM/BP, VCM | VCM + CAZ# (1) | Vit + PEA + s/o (1) | CF | 20/200 (3) |
| 5† | OS | PD | S.aureus, S.agalactiae | + | ND | CEZ, ST, MEPM, F-FLCZ, CDTR-PI | None | — | 20/600 | 20/25 (78) | |
| 6 | OS | PF (Pos) | Nocardia farcinica | + | −※4 | MCFG, F-FLCZ, MEPM, IPM/CS, ST | None | — | 20/50 | 20/40 (313)§1 | |
| 7 | OS | Pan | S.equisimilis | + | + (AQ+) | PCG, CTRX, GM, TAZ/PIPC |
VCM + MEPM (<1) | — | LP | Phthisis (57) | |
| 8† | OD | PD | MRSA | ND | − | IV cannula (MRSA) | CPR, VCM | VCM + CAZ# (9) | Vit + PEA (37) | LP | Phthisis (2) |
| 9 | OD | PF (Pos) | MRSA | + | ND | CAZ, BIPM, CEZ, CTM | None | — | 20/20 | 20/25 (35) | |
| 10 | OD OS |
PD PD |
S.pneumoniae | + | − − |
CPR, TAZ/PIPC, PIPC, FMOX, CFPN-PI | VCM + CAZ# (28) VCM + CAZ# (8 & 15) |
Vit + PEA + s/o (30) Vit + PEA (10) |
LP HM |
LP (196) HM (196) |
|
| 11 | OD OS |
PF PF |
Unknown | − | ND | Sputum (MRSA) | FOM, CZOP, CTRX, GM, VCM, LZD | None None |
— | 20/32 20/28 |
20/16 (113) 20/16 (113) |
| 12 | OS | Pan | K. pneumoniae | − | + (AQ+) | CPR, CEZ, IPM/CS. CTRX |
None | Enucleation (9) | LP | NLP (4) | |
| 13† | OD OS |
PF (T) PD |
MRSA | + | ND | CFDN, MEPM, MINO, MCFG, F-FLCZ, BIPM, LVFX, TAZ/PIPC, VCM, LZD | None None |
— | ND | Death (3) | |
| 14† | OD OS |
PF (N) PF (N) |
MRSA | + | (AQ−) (AQ−) |
VCM, TEIC | VCM + CAZ (8 & 15) VCM + CAZ (15) |
— | 20/500 20/500 |
20/250 (14) 20/200 (14) |
|
| 15 | OS | PF (N) | S.agalactiae | + | ND | AZM, IPM/CS, GM | None | — | CF | 20/20 (33) | |
| 16 | OD | PD | Unknown | − | (AQ−) | CZOP | VCM + CAZ (4) | — | HM | HM (15) | |
| 17† | OS | PD | MRSA | + | (AQ−) | VCM, F-FLCZ | VCM (<1 & 2) | — | HM | 20/60 (7) | |
| 18 | OS | PD | Neisseria sp. | + ‡
S.aureus |
+ | VCM, MEPM, CEZ, MCFG, FLCZ |
VCM + CAZ# (22) | Vit (22) | 20/25 | 20/20 (7) | |
| 19† | OD OS |
PF (SupN) Pan |
S.aureus | + | + | MINO, DRPM, LZD, CEZ | VCM + CAZ (<1) None |
— Enucleation (23) |
20/20 NLP |
20/100§2 (67) NLP (67) |
|
| 20 | OS | PF (SupN) | MRSA | − | ND | Leg abscess (MRSA) | ST, CTRX, LZD | None | — | 20/20 | 20/20 (44) |
| 21† | OD OS |
PF (T) PF (T) |
MRSA, E.cloacae | + | ND | IV cannula (MRSA) | CFPM, F-FLCZ, LZD, DAP, RFP, ST | VCM (9) VCM (16) |
— | 20/100 20/40 |
20/20 (39) 20/50§3 (39) |
†Hospital-acquired patient, ※1site of subretinal abscess in parentheses, ※2number in parentheses represents days from diagnosis of endophthalmitis, ※3number in parentheses represents days from onset of ocular symptoms, and ※4diagnostic vitrectomy; OD, right eye; OS, left eye; EBE, endogenous bacterial endophthalmitis; Pan, panophthalmitis; PD, posterior diffuse; PF, posterior focal: N, nasal; T, temporal; L, lower; Pos, posterior; SupT, superior temporal; SupN, superior nasal; CNS, coagulase-negative Staphylococcus; MRSA, methicillin-resistant Staphylococcus aureus; AQ, aqueous; ND, not done; IV, intravenous; VA, visual acuity; Vit, vitrectomy; PEA, phacoemulsification and aspiration; s/o, silicone oil; NLP, no light perception; CF, counting fingers; LP, light perception; HM, hand motion; §1cataract and epiretinal membrane; §2vitreous hemorrhage; §3cataract; #vitrectomy and intravitreal injection; ‡not detected Neisseria sp. from blood culture; TAZ/PIPC, tazobactam/piperacillin; PIPC, piperacillin; PCG, benzyl penicillin; ASPC, aspoxicillin; CTRX, ceftriaxone; CEZ, cefazolin; CPR, cefpirome; CZOP, cefozopran; CDTR-PI, cefditoren pivoxil; CTM, cefotiam; CFDN, cefdinir; CAZ, ceftazidime; CFPM, cefepime; FMOX, flomoxef; CFPN-PI, cefcapene pivoxil; IPM/CS, imipenem/cilastatin; MEPM, meropenem; BIPM, biapenem; PAPM/BP, panipenem/betamipron; DRPM, doripenem; GM, gentamicin; AZM, azithromycin; CLDM, clindamycin; MINO, minocycline; LZD, linezolid; VCM, vancomycin; TEIC, teicoplanin; DAP, daptomycin; LVFX, levofloxacin; RFP, rifampicin; ST, sulfamethoxazole; FOM, fosfomycin; F-FLCZ, fosfluconazole; MCFG, micafungin.