Evaluation of the effect of gentamicin in surgical perfusion solution on cataract postoperative endophthalmitis

Ma, Wenjiang; Hou, Guirong; Wang, Junfang; Liu, Ting; Tian, Fang

doi:10.1186/s12886-022-02633-2

Cited by 4 publications

(4 citation statements)

References 45 publications

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“…On the other hand, gentamicin attained good out-turn in reducing the incidence of endophthalmitis when injected into the surgical perfusion solution. Still, some results indicate that gentamicin may ease the development of resistant strains of Enterococcus [82]. For the prophylaxis of endophthalmitis after intravitreal injections with anti-VEGF, aminoglycosides are not indicated, especially when they are associated with corticosteroids, as the risk of infection is actually higher for the later compared to no antibiotic prophylaxis [63,83,84].…”

Section: Discussionmentioning

confidence: 99%

Susceptibility of Ocular Surface Bacteria to Various Antibiotic Agents in a Romanian Ophthalmology Clinic

Ghita,

Iliescu,

Ghita

et al. 2023

Diagnostics

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Periodic assessment of bacterial contamination is necessary as it allows proper guidance in cases of eye infections through the use of appropriate antibiotics. Due to the extensive use of antibiotic treatment, many strains of the microbiota that cause infections are resistant to the usual ophthalmic antibiotics. The present study provides an updated assessment of the susceptibility of Gram-positive and Gram-negative bacteria found on the ocular surface to the most commonly used antibiotic agents in patients undergoing cataract surgery. A total of 993 patients were included in the study with ages between 44 and 98 years old. Conjunctival cultures were collected 7 days before cataract surgery. The response of Gram-positive and Gram-negative bacteria to various antibiotic classes, such as glycopeptides, cephalosporins, carbapenems, fluoroquinolones, aminoglycosides, phenicols, tetracyclines, rifamycins, macrolides and penicillins, was assessed. From the tested antibiotics, vancomycin had 97.8% efficacy on Gram-positive bacteria. In the cephalosporin category, we observed a high level of resistance of the cefuroxime for both Gram-positive and negative bacteria. Antibiotics that have more than 90% efficacy on Gram-positive bacteria are meropenem, imipenem, netilmicin, amikacin and rifampicin. On Gram-negative bacteria, we found 100% efficacy of all tested fluoroquinolones, i.e., aminoglycosides (except for tobramycin), doxycycline, azithromycin, clarithromycin and chloramphenicol. The current study illustrates patterns of increased resistance in certain bacteria present on the ocular surface to some of the commonly used antibiotics in ophthalmological clinical practice. One such revealing example is cefuroxime, which has been highly used as an intracameral antibiotic for the prevention of bacterial endophthalmitis after cataract surgery.

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Section: Discussionmentioning

confidence: 99%

Susceptibility of Ocular Surface Bacteria to Various Antibiotic Agents in a Romanian Ophthalmology Clinic

Ghita,

Iliescu,

Ghita

et al. 2023

Diagnostics

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“…Another proposed technique is to use an IOL loaded with antibiotics (moxifloxacin, gatifloxacin) and anti-inflammatories (ketorolac). The latter would allow a sustained and extended drug release with the challenge of avoiding a negative effect on the lens’ physical properties or on the surrounding ocular tissues [ 127 , 128 , 129 , 130 , 131 , 132 ].…”

Section: Current Prophylactic Measures and Management Approachesmentioning

confidence: 99%

New Approaches to Overcoming Antimicrobial Resistance in Endophthalmitis

Garcia O’Farrill,

Abi Karam,

Villegas

et al. 2024

Pharmaceuticals

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Endophthalmitis is a rare but vision-threatening infection characterized by marked inflammation of intraocular fluids and tissues, uncommonly seen following surgery and intravitreal injection. Antimicrobials are used worldwide in the prophylaxis and treatment of bacterial and fungal infections of the eye and are standard treatment in the preoperative and postoperative care of surgical patients. However, antimicrobials are reported to be overprescribed in many parts of the world, which contributes to antimicrobial resistance (AMR). AMR complicates the prophylaxis and treatment of endophthalmitis. This article examines the prevalence and mechanisms of AMR in ocular microorganisms, emphasizing the importance of understanding AMR patterns for tailored treatments. It also explores prophylaxis and management strategies for endophthalmitis, with a discussion on the use of intracameral antibiotic administration. The use of prophylactic intracameral antibiotics during cataract surgery is common in many parts of the world but is still controversial in some locations, especially in the US. Finally, it highlights the role of stewardship in ophthalmology and its benefits in the treatment of endophthalmitis.

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“…In most cases, endophthalmitis is caused by the presence of bacteria found on the palpebral margin and tear film of the patient's conjunctival flora [7] . Other possible sources of infection may be the contamination of equipment, instruments, supplies, solutions, surgical drapes, lenses, or lack of good practice by health professionals [7,8] According to a study carried out in Poland, after more than one million facectomy surgeries, in a period of five years, the incidence rate of endophthalmitis was 0.066% [9] .…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

“…In most cases, endophthalmitis is caused by the presence of bacteria found on the palpebral margin and tear film of the patient’s conjunctival flora [7] . Other possible sources of infection may be the contamination of equipment, instruments, supplies, solutions, surgical drapes, lenses, or lack of good practice by health professionals [7, 8] .…”

Section: Introductionmentioning

confidence: 99%

Major outbreak of endophthalmitis after cataract surgery: a retrospective cohort in northern Brazil

Pereira¹,

Sabini²,

Almeida³

et al. 2023

Preprint

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Background: Endophthalmitis is one of the most important adverse events after cataract surgery as it can lead to total vision loss. The aim of this study was to describe the occurrence of endophthalmitis after phacoemulsification with intraocular lens implantation among patients assisted during a joint effort in Porto Velho, Rondonia, Brazil. Method: This is a retrospective cohort study, carried out from a bank with 649 medical records of patients who underwent surgery. Descriptive analysis and multiple analysis using Robust Poisson Regression were performed to estimate relative risks (RR) and 95% confidence intervals (95%CI). A statistical analysis was performed using the statistical program Stata version 16.0 (College Station, Texas, USA). Results: The incidence of postoperative endophthalmitis confirmed by culture was 10.88%, the highest ever recorded in the world. A higher risk for endophthalmitis was found, in probable cases, among males (RR: 1.88; 95%CI:1.03; 3.44) and brown and yellow skin color (RR: 2.78; 95 %CI %: 1.17; 6.60). For confirmed and probable cases, bilateral surgery and specific lens model were also risk factors. The predominant etiological agents were gram-negative and the main clinical manifestation was corneal edema. The average number of days to start treatment was eight days and 27.12% used antibiotics. Conclusion: Specific protocols are needed for cataract surgeries that encompass hiring, performing and monitoring these services to ensure good practices and patient safety.

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Evaluation of the effect of gentamicin in surgical perfusion solution on cataract postoperative endophthalmitis

Cited by 4 publications

References 45 publications

Susceptibility of Ocular Surface Bacteria to Various Antibiotic Agents in a Romanian Ophthalmology Clinic

Susceptibility of Ocular Surface Bacteria to Various Antibiotic Agents in a Romanian Ophthalmology Clinic

New Approaches to Overcoming Antimicrobial Resistance in Endophthalmitis

Major outbreak of endophthalmitis after cataract surgery: a retrospective cohort in northern Brazil

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