Endoftalmites bacterianas com culturas positivas: uma revisão de 6 anos

• Autor(a) principal: Bispo, Paulo José Martins [UNIFESP]
• Data de Publicação: 2008
• Outros Autores: Melo, Gustavo Barreto de [UNIFESP], D'azevedo, Pedro Alves, Hofling-Lima, Ana Luisa [UNIFESP], Yu, Maria Cecília Zorat [UNIFESP], Pignatari, Antonio Carlos Campos [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0004-27492008000500002; http://repositorio.unifesp.br/handle/11600/4564
• topic: Eye infections, bacterial; Endophthalmitis; Aqueous humor; Drug resistance, microbial; Microbial sensitivity tests; Infecções oculares bacterianas; Endoftalmite; Humor aquoso; Resistência microbiana a medicamentos; Testes de sensibilidade microbiana

PURPOSE: To assess the distribution of microorganisms isolated from patients with bacterial endophthalmitis and their antimicrobial susceptibility. METHODS: Retrospective analysis of medical and microbiological records of patients with suspected diagnosis of endophthalmitis and bacterial culture-proven at the Department of Ophthalmology, UNIFESP, between January 1 2000 and December 31 2005. RESULTS: 153 (33.9%) of 451 patients showed positive bacterial culture. A total of 155 microorganisms were isolated, 79.35% were gram-positive and 20.65% gram-negative. Staphylococcus (CoNS) (41.94%) were the most frequently isolated. The antimicrobial susceptibility for gram-negative microorganisms was as follows: amikacin 87.10%, tobramycin 80.65%, ciprofloxacin 96.67%, levofloxacin, gatifloxacin and moxifloxacin 100%, ceftazidime 85.0%, and gentamicin 80.65%. Vancomycin sensitivity among gram-positive microorganisms was 100%. S. aureus and CoNS showed 83.33% of susceptibility to oxacillin, 89.61% to ciprofloxacin and 100% to gatifloxacin and moxifloxacin. The main acquisition mechanism was postoperative (60.65%). CONCLUSION: We detected a low sensitivity of vitreous/aqueous culture for the etiologic diagnosis of endophthalmitis. The empiric antimicrobial therapy or prophylaxis should be active against gram-positive bacteria, particularly staphylococci. Surveillance studies of bacterial resistance are important for a better utilization of antimicrobials in this clinical setting.