Endophthalmitis caused by Acinetobacter baumanni: a case series

Abstract

Purpose To profile the etiology, clinical outcomes and drug sensitivity patterns in endophthalmitis caused by Acinetobacter baumanni. Methods Retrospective analysis of all the cases of Acinetobacter baumanni endophthalmitis presenting to tertiary referral care ophthalmic hospital in Eastern India from January 2009 to December 2011 were done. Results A total of four cases were included in the study. Out of the four cases one was post traumatic and the rest were post cataract surgery. All the cases underwent vitreoretinal surgical intervention followed by intravitreal antibiotics. A. Baumanni was isolated from vitreous in all the cases. Among all the drugs tested bacteria were found sensitive to ciprofloxacin (100 %) whereas all tested resistant to ceftazidime. Out of the four cases one had to be eviscerated, another developed retinal detachment post vitrectomy, one was phthisical at final followup, and only one patient achieved a vision of 20/200 with clear media and attached retina at final visit. Conclusion A. Baumanni is a very rare cause of endophthalmitis with poor visual and anatomical outcomes. Ciprofloxacin should be considered as first the line intravitreal antibiotic.

Modeling intraocular bacterial infections

“…Acinetobacter spp. is a rare cause of endophthalmitis (Roy et al, 2013), but these cases almost always have a poor anatomical and visual outcome. Acinetobacter spp.…”

Post Cataract Surgery Endophthalmitis Caused by Acinetobacter Baumannii

“…Chen et al 2 has reported two cases, one was endogenous and other was post keratoplasty with outcome of 20/60 in 1 case and No PL in other. While out of four cases reported by Roy R et al3 three were post cataract surgery and one post trauma and they could salvage only one eye with visual outcome of 20/200. Favourable outcome after good microbiological evaluation and timely performed vitrectomy was reported by G. Biigren et al4 in their case report.…”

“…Few reports of post cataract endophthalmitis by A.Baumannii are reported in literature, indicating poorer visual and anatomical outcomes in maximum cases, despite intensive management. [1][2][3][4] It is a slow growing gram negative bacterium which is generally an inhabitant of soil, vegetation and aquatic environment. It has emerged as one of the most troublesome pathogens for health care professionals because of its resistance to multiple drugs, as reported in various case series.…”

“…High level of sensitivity to Ciprofloxacin was reported by Gopal et al5 in another sub-species of acinetobacter, while Chen et al 2 reported sensitivity to Imipenem in their series. Roy R et al3 reported 100% sensitivity to Ciprofloxacin and 100% resistance to Ceftazidime. In our case the bacteria was resistant to Ciprofloxacin and other fluoroquinolones while highly sensitive to Colistin, Ceftazidime and Doxycycline.…”

Acinetobacter Corneal Ulcer, an Ocular Involvement by an Uncommon Organism; a Case Report and a Review of Literature

“…All these patients underwent intravitreal antibiotic (Cipro oxacin) and vitreoretinal surgical intervention. Finally, ocular condition of 3 of them deteriorated (one resulted in evisceration, one in phthisic eye and the other one developed retinal detachment, post vitrectomy) and only 1 patients reached to the visual acuity of 20/200(8). Recently a case of Acinetobacter baumanni endophthalmitis has been reported, which resulted from intravitreal Ranibizumab injection(9).…”