Endophthalmitis caused by streptococcal species: clinical settings, microbiology, management, and outcomes.
Endophthalmitis caused by streptococcal species: clinical settings, microbiology, management, and outcomes.
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DOI：
10.1016/j.ajo.2013.12.026
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发表时间：
2014-04
影响因子：
4.2
通讯作者：
Miller, Darlene
中科院分区：
文献类型：
--
作者：
Kuriyan, Ajay E.;Weiss, Kathleen D.;Flynn, Harry W., Jr.;Smiddy, William E.;Berrocal, Audina M.;Albini, Thomas A.;Miller, Darlene
报告链球菌引起的眼内炎的临床情况、抗生素敏感性和预后。回顾性观察性病例系列。单中心研究评估了2000年1月1日至2011年12月31日期间所有由链球菌引起的培养阳性眼内炎患者。63例患者符合研究标准。最常见的临床情况是水泡相关（17.27%）、玻璃体内注射后（16.25%）和白内障手术后（13.21%）。分离株分别为绿脓杆菌（47.71%）、肺炎脓脓杆菌（13.21%）和β溶血性链球菌（5.8%）。63株中有60株（95%）对万古霉素敏感，48株中有47株（98%）对头孢曲松（第三代头孢菌素）敏感，61株中有57株（93%）对左氧氟沙星（第三代氟喹诺酮）敏感。在研究的前半期和后半期，抑制90%菌株所需的抗生素的最低抑制浓度（MIC）对头孢曲松和左氧氟沙星分别增加了1.5倍和2倍，对万古霉素则保持不变。初始治疗为玻璃体穿刺（49.78%）或玻璃体切割（14.22%）；所有患者均接受玻璃体内抗生素治疗。视力结果是可变的；最佳矫正视力≥20/400 16例（25%），<20/400 47例（75%）。16例（25%）患者进行了内脏摘除/去核手术。链球菌对常用抗生素的敏感性普遍较高。在研究的后半期，与前半部分相比，需要更高的抗生素mic才能在体外抑制90%的分离株。尽管得到了及时的治疗，但大多数患者的预后不佳。
To report the clinical settings, antibiotic susceptibilities, and outcomes of endophthalmitis caused by Streptococcus species. Retrospective, observational case series. Single-center study evaluating all patients with culture-positive endophthalmitis caused by Streptococcus species between January 1, 2000 and December 31, 2011. Study criteria were met by 63 patients. The most common clinical settings were bleb-associated (17, 27%), post-intravitreal injection (16, 25%), and post-cataract surgery (13, 21%). The isolates were S. viridans (47, 71%), S. pneumoniae (13, 21%), and β-hemolytic Streptococci (5, 8%). Sixty (95%) of 63 isolates were susceptible to vancomycin, 47 (98%) of 48 to ceftriaxone (third generation cephalosporin), and 57 (93%) of 61 to levofloxacin (third generation fluoroquinolone). Between the first and second half of the study period, the minimal inhibitory concentration (MIC) of antibiotics required to inhibit 90% of isolates increased by 1.5-fold for ceftriaxone and 2-fold for levofloxacin, and remained the same for vancomycin. Initial treatment was vitreous tap (49, 78%) or pars plana vitrectomy (14, 22%); all received intravitreal antibiotics. Visual acuity outcomes were variable; best corrected visual acuity (BCVA) was ≥20/400 in 16 (25%) patients and <20/400 in 47 (75%) patients. Evisceration/enucleation was performed in 16 (25%) patients. Streptococcus isolates generally had high susceptibility rates to commonly used antibiotics. Higher antibiotic MICs were required to inhibit 90% of isolates in vitro in the second half of the study period compared to the first half. Despite prompt treatment, the majority of patients had poor outcomes.
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DOI：
10.1097/iae.0b013e31820a67e4
发表时间：
2011-04-01
影响因子：
3.3
作者：
McCannel, Colin A.
通讯作者：
McCannel, Colin A.
影响因子：
2.2
作者：
Jacobs, David J.;Leng, Theodore;Gedde, Steven J.
通讯作者：
Gedde, Steven J.
影响因子：
4.2
作者：
Wykoff, Charles C.;Parrott, M. Brandon;Alfonso, Eduardo C.
通讯作者：
Alfonso, Eduardo C.
影响因子：
4.2
作者：
Goldberg, Roger A.;Flynn, Harry W., Jr.;Gonzalez, Serafin
通讯作者：
Gonzalez, Serafin
影响因子：
4.4
作者：
Schulze-Bonsel, K;Feltgen, N;Bach, M
通讯作者：
Bach, M