Evolving Fluoroquinolone Resistance Among Coagulase-Negative Staphylococcus Isolates Causing Endophthalmitis

Schimel, Andrew M.; Miller, Darlene; Flynn, Harry W.

doi:10.1001/archophthalmol.2012.2348

Cited by 32 publications

(27 citation statements)

References 6 publications

(4 reference statements)

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“…Previous studies have shown an increased rate of antibiotic-resistant coagulase-negative Staphylococcus strains in the conjunctiva of patients receiving multiple courses of local antibiotic therapy [27-29]. Furthermore, there are reports of an increased rate of endophthalmitis cases caused by antibiotic-resistant coagulase-negative Staphylococcus over the last two decades [30, 31]. It is suspected that antibiotic-resistant strains cause more inflammation and destruction of the infected retina than nonresistant pathogens, as shown in an animal model [32].…”

Section: Discussionmentioning

confidence: 99%

Causative Pathogens of Endophthalmitis after Intravitreal Anti-VEGF Injection: An International Multicenter Study

et al. 2019

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Purpose: The main objective of this study was to investigate the microbiological spectrum of endophthalmitis after anti-VEGF injections and to compare streptococcal with non-streptococcus-associated cases with regard to baseline characteristics and injection procedure. Methods: Retrospective, international multicenter study of patients with culture-positive endophthalmitis after intravitreal anti-VEGF injection at 17 different retina referral centers. Results: Eighty-three cases with 87 identified pathogens were included. Coagulase-negative staphylococci (59%) and viridans streptococci (15%) were the most frequent pathogens found. The use of postoperative antibiotics and performance of injections in an operating room setting significantly reduced the rate of streptococcus-induced endophthalmitis cases (p = 0.01 for both). Conclusion: We found a statistically significant lower rate of postinjectional local antibiotic therapy and operating room-based procedures among the streptococcus-induced cases compared to cases caused by other organisms.

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Section: Discussionmentioning

confidence: 99%

Causative Pathogens of Endophthalmitis after Intravitreal Anti-VEGF Injection: An International Multicenter Study

et al. 2019

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“…The biofilm-associated homologue protein, Bhp, is also possibly involved in biofilm accumulation (8). In addition, the association between biofilm formation capability and the emerging resistance to antibiotics used routinely for prophylaxis and treatment of ocular infections (9,10) increases the success of S. epidermidis as an ocular pathogen. Although beta-lactams are not frequently used in ophthalmology, methicillin resistance is a key mechanism of resistance in staphylococci and is significantly associated with higher resistance rates to other non-beta-lactam agents, contributing to the spread and persistence of multidrugresistant strains in several settings.…”

mentioning

confidence: 99%

Characterization of Ocular Methicillin-Resistant Staphylococcus epidermidis Isolates Belonging Predominantly to Clonal Complex 2 Subcluster II

2014

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Staphylococcus epidermidis is an abundant member of the microbiota of the human skin and wet mucosa, which is commonly associated with sight-threatening infections in eyes with predisposing factors. Ocular S. epidermidis has become notorious because of its capability to form biofilms on different ocular devices and due to the evolving rates of antimicrobial resistance. In this study, the molecular epidemiology of 30 ocular methicillin-resistant S. epidermidis (MRSE) isolates was assessed using multilocus sequence typing (MLST). Antimicrobial resistance, accessory gene-regulator and staphylococcal cassette chromosome mec (SCCmec) types, biofilm formation, and the occurrence of biofilm-associated genes were correlated with MLST clonal complexes. Sequence types (STs) frequently found in the hospital setting were rarely found in our collection. Overall, 12 different STs were detected with a predominance of ST59 (30%), ST5 and ST6 (13.3% each). Most of the isolates (93.3%) belonged to the clonal complex 2 (CC2) and grouped mainly within subcluster CC2-II (92.9%). Isolates grouped within this subcluster were frequently biofilm producers (92.3%) with a higher occurrence of the aap (84.5%) and bhp (46.1%) genes compared to icaA (19.2%). SCCmec type IV (53.8%) was predominant within CC2-II strains, while 38.4% were nontypeable. In addition, CC2-II strains were frequently multidrug resistant (80.7%) and demonstrated to be particularly resistant to ciprofloxacin (80.8%), ofloxacin (77%), azithromycin (61.5%), and gentamicin (57.7%). Our findings demonstrate the predominance of a particular MRSE cluster causing ocular infections, which was associated with high rates of antimicrobial resistance and particularly the carriage of biofilm-related genes coding for proteinaceous factors implicated in biofilm accumulation.

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“…Even the susceptibility of Gram-positive cocci for ciprofloxacin has decreased from 86% to 62.9% 1. Increasing resistance to fluoroquinolones has been noted in other studies as well 5. However, the results obtained in this study may not be extrapolated in other populations where the spectrum and antimicrobial susceptibility of endophthalmitis isolates is different 2–4…”

Section: Discussionmentioning

confidence: 49%

Microbiologic spectrum and susceptibility of isolates in acute postcataract surgery endophthalmitis: are they same as they were more than a decade ago?

et al. 2013

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Evolving Fluoroquinolone Resistance Among Coagulase-Negative Staphylococcus Isolates Causing Endophthalmitis

Cited by 32 publications

References 6 publications

Causative Pathogens of Endophthalmitis after Intravitreal Anti-VEGF Injection: An International Multicenter Study

Causative Pathogens of Endophthalmitis after Intravitreal Anti-VEGF Injection: An International Multicenter Study

Characterization of Ocular Methicillin-Resistant Staphylococcus epidermidis Isolates Belonging Predominantly to Clonal Complex 2 Subcluster II

Microbiologic spectrum and susceptibility of isolates in acute postcataract surgery endophthalmitis: are they same as they were more than a decade ago?

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