Point: Fluoroquinolone-Based Antibacterial Chemoprophylaxis in Neutropenic Cancer Patients Works for Defined Outcomes in Defined Populations, but Must Be Used Wisely

2004 ◽  
Vol 2 (5) ◽  
pp. 433-444 ◽  
Author(s):  
Eric J. Bow
Keyword(s):  
Viridans Streptococci ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Gram Negative ◽  
Prescribing Behavior ◽  
Phase Ii Clinical Trials ◽  
Empirical Antibacterial Therapy ◽  
Invasive Infections ◽  
Neutropenic Patients ◽  
Related Mortality

Fluoroquinolone-based antibacterial chemoprophylaxis administered in situations in which the prevalence of fluoroquinolone-resistant Escherichia coli is low (<3% to 5%) can reliably reduce the risk for invasive gram-negative bacillary infection, and, if supplemented by gram-positive agents such as rifampin, penicillin, or macrolides, can reduce the risk of developing invasive infections caused by gram-positive microorganisms, including Viridans streptococci and coagulase-negative staphylococci. In the published literature, fluoroquinolone-based chemoprophylaxis does not reliably reduce the incidence of febrile neutropenic episodes, neutropenic episode-related mortality, or physician-initiated systemic antimicrobial prescribing behavior. Prophylaxis should only be prescribed in defined patient populations from the first day of cytotoxic therapy until neutrophil regeneration in environments in which the prevalence of gram-negative bacillary resistance to the prophylaxis strategy is low. Small phase II clinical trials suggest that empirical antibacterial therapy of unexplained fevers in neutropenic patients receiving effective fluoroquinolone-based prophylaxis under defined epidemiologic circumstances may be safely discontinued early. Better discriminators of infection in febrile neutropenic patients are needed.

Impact of empirical antibiotic regimens on mortality in neutropenic patients with bloodstream infection presenting with septic shock

2021 ◽  
Author(s):  
Mariana Chumbita ◽  
Pedro Puerta-Alcalde ◽  
Carlota Gudiol ◽  
Nicole Garcia-Pouton ◽  
Júlia Laporte-Amargós ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Kidney Injury ◽  
Bloodstream Infections ◽  
Gram Positive ◽  
Gram Negative ◽  
Neutropenic Patients ◽  
Prospective Cohorts ◽  
Independent Risk Factors ◽  
The Impact

Objectives: We analyzed risk factors for mortality in febrile neutropenic patients with bloodstream infections (BSI) presenting with septic shock and assessed the impact of empirical antibiotic regimens. Methods: Multicenter retrospective study (2010-2019) of two prospective cohorts comparing BSI episodes in patients with or without septic shock. Multivariate analysis was performed to identify independent risk factors for mortality in episodes with septic shock. Results: Of 1563 patients with BSI, 257 (16%) presented with septic shock. Those patients with septic shock had higher mortality than those without septic shock (55% vs 15%, p<0.001). Gram-negative bacilli caused 81% of episodes with septic shock; gram-positive cocci, 22%; and Candida species 5%. Inappropriate empirical antibiotic treatment (IEAT) was administered in 17.5% of septic shock episodes. Empirical β-lactam combined with other active antibiotics was associated with the lowest mortality observed. When amikacin was the only active antibiotic, mortality was 90%. Addition of empirical specific gram-positive coverage had no impact on mortality. Mortality was higher when IEAT was administered (76% vs 51%, p=0.002). Age >70 years (OR 2.3, 95% CI 1.2-4.7), IEAT for Candida spp. or gram-negative bacilli (OR 3.8, 1.3-11.1), acute kidney injury (OR 2.6, 1.4-4.9) and amikacin as the only active antibiotic (OR 15.2, 1.7-134.5) were independent risk factors for mortality, while combination of β-lactam and amikacin was protective (OR 0.32, 0.18-0.57). Conclusions: Septic shock in febrile neutropenic patients with BSI is associated with extremely high mortality, especially when IEAT is administered. Combination therapy including an active β-lactam and amikacin results in the best outcomes.

Influence of Selective Bowel Decontamination on the Organisms Recovered During Bacteremia in Neutropenic Patients

2004 ◽  
Vol 25 (8) ◽  
pp. 685-689 ◽  
Author(s):  
Florian Daxboeck ◽  
Werner Rabitsch ◽  
Alexander Blacky ◽  
Maria Stadler ◽  
Paul A. Kyrle ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Bone Marrow ◽  
Anaerobic Bacteria ◽  
Blood Cultures ◽  
University Teaching ◽  
Coagulase Negative Staphylococci ◽  
Gram Negative ◽  
Neutropenic Patients ◽  
Care Ward

AbstractObjective:To assess the influence of prophylactic selective bowel decontamination (SBD) on the spectrum of microbes causing bloodstream infection (BSI).Design:The microbes causing BSI in neutropenic patients of a hematologic ward (HW) and a bone marrow transplantation unit (BMTU), respectively, were compared by retrospective analysis of blood culture results from January 1996 to June 2003.Setting:A 30-bed HW (no SBD) and a BMTU including a 7-bed normal care ward and an 8-bed intensive care unit (SBD used) of a 2,200-bed university teaching hospital.Results:The overall incidences of bacteremia in the HW and the BMTU were similar (72.6 vs 70.6 episodes per 1,000 admissions; P = .8). Two hundred twenty episodes of BSI were recorded in 164 neutropenic patients of the HW and 153 episodes in 127 neutropenic patients of the BMTU. Enterobacteriaceae (OR, 3.14; CI95, 1.67–5.97; P = .0002) and Streptococcus species (OR, 2.04; CI95, 1.14–3.70; P = .015) were observed more frequently in HW patients and coagulase-negative staphylococci more frequently in BMTU patients (OR, 0.15; CI95, 0.09–0.26; P< .00001). No statistically significant differences were found for gram-negative nonfermentative bacilli (P = .53), Staphylococcus aureus (P = .21), Enterococcus species (P = .48), anaerobic bacteria (P = .1), or fungi (P = .50).Conclusions:SBD did not lead to a significant reduction in the incidence of bacteremia, but significant changes in microbes recovered from blood cultures were observed. SBD should be considered when empiric antimicrobial therapy is prescribed for suspected BSI.

THE STRUCTURE OF CONDITIONALLY PATHOGENIC MICROFLORA, ISOLATED FROM THE UROGENITAL TRACT OF WOMEN WITH PATHOLOGICAL COURSE OF PREGNANCY

2020 ◽  
Vol 65 (1) ◽  
pp. 50-54
Author(s):  
A. V. Kozlov ◽  
A. V. Lyamin ◽  
A. V. Zhestkov ◽  
O. A. Gusyakova ◽  
E. I. Popova ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Inflammatory Diseases ◽  
The Body ◽  
Urogenital Tract ◽  
Quantitative Composition ◽  
Cervical Canal ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Gram Negative ◽  
Staphylococcus Spp

The structure of the microflora of the urogenital tract of a woman is variable and diverse, changing its qualitative and quantitative composition can affect various physiological processes in the body of a woman, including the course of pregnancy. In this study, the results of cultures of 1415 samples of urine and cervical canal discharge of pregnant women were analyzed. Species identification was carried out by MALDI-ToF mass spectrometry using Microflex LT (Bruker) mass spectrometer. Gram-positive bacteria (69.5%) dominated the structure of the cervical canal microflora, among which Staphylococcus spp prevailed., Enterococcus spp. and Lactobacillus spp. Among gram-negative bacteria most often encountered microorganisms of the order Enterobacteriales, the predominant species among which was E. coli. Also, yeast-like fungi were isolated from the material of the cervical canal, their number was 11% of the total number of crops. Qualitative microbiological composition of urine was represented by gram-positive flora (68.7%), gram-negative flora (30.1%) and Candida fungi (1.2%). There is a significant predominance of coagulase-negative staphylococci (97.3%) over coagulase-positive (2.7%) in the structure of gram-positive microorganisms. The composition of gram-negative flora is mainly represented by bacteria of the order Enterobacteriales (71.4%). The study identified microorganisms that can cause postpartum complications and the development of inflammatory diseases of the newborn, which suggests the need for regular microbiological examination for pregnant women.

scholarly journals In VitroActivity of AZD0914, a Novel Bacterial DNA Gyrase/Topoisomerase IV Inhibitor, against Clinically Relevant Gram-Positive and Fastidious Gram-Negative Pathogens

2015 ◽  
Vol 59 (10) ◽  
pp. 6053-6063 ◽  
Author(s):  
Douglas J. Biedenbach ◽  
Michael D. Huband ◽  
Meredith Hackel ◽  
Boudewijn L. M. de Jonge ◽  
Daniel F. Sahm ◽  
...  
Keyword(s):  
Bacterial Species ◽  
Dna Gyrase ◽  
Species Group ◽  
Coagulase Negative Staphylococci ◽  
Topoisomerase Iv ◽  
Gram Positive ◽  
Bacterial Dna ◽  
Gram Negative ◽  
Content Type

ABSTRACTAZD0914, a new spiropyrimidinetrione bacterial DNA gyrase inhibitor with a novel mode of inhibition, has activity against bacterial species commonly cultured from patient infection specimens, including fluoroquinolone-resistant isolates. This study assessed thein vitroactivity of AZD0914 against key Gram-positive and fastidious Gram-negative clinical isolates collected globally in 2013. AZD0914 demonstrated potent activity, with MIC90s for AZD0914 of 0.25 mg/liter againstStaphylococcus aureus(n= 11,680), coagulase-negative staphylococci (n= 1,923), streptococci (n= 4,380), andMoraxella catarrhalis(n= 145), 0.5 mg/liter againstStaphylococcus lugdunensis(n= 120) andHaemophilus influenzae(n= 352), 1 mg/liter againstEnterococcus faecalis(n= 1,241), and 2 mg/liter againstHaemophilus parainfluenzae(n= 70). The activity againstEnterococcus faeciumwas more limited (MIC90, 8 mg/liter). The spectrum and potency of AZD0914 included fluoroquinolone-resistant isolates in each species group, including methicillin-resistant staphylococci, penicillin-resistant streptococci, vancomycin-resistant enterococci, β-lactamase-producingHaemophilusspp., andM. catarrhalis. Based on thesein vitrofindings, AZD0914 warrants further investigation for its utility against a variety of Gram-positive and fastidious Gram-negative bacterial species.

scholarly journals In Vitro Activities of ME1036 (CP5609), a Novel Parenteral Carbapenem, against Methicillin-Resistant Staphylococci

2004 ◽  
Vol 48 (8) ◽  
pp. 2831-2837 ◽  
Author(s):  
Mizuyo Kurazono ◽  
Takashi Ida ◽  
Keiko Yamada ◽  
Yoko Hirai ◽  
Takahisa Maruyama ◽  
...  
Keyword(s):  
Multiple Drug ◽  
Gram Negative Bacteria ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Gram Negative ◽  
Methicillin Resistant ◽  
Gram Positive Bacteria ◽  
Multiple Drug Resistant ◽  
Time Kill

ABSTRACT ME1036, formerly CP5609, is a novel parenteral carbapenem with a 7-acylated imidazo[5,1-b]thiazole-2-yl group directly attached to the carbapenem moiety of the C-2 position. The present study evaluated the in vitro activities of ME1036 against clinical isolates of gram-positive and gram-negative bacteria. ME1036 displayed broad activity against aerobic gram-positive and gram-negative bacteria. Unlike other marketed β-lactam antibiotics, ME1036 maintained excellent activity against multiple-drug-resistant gram-positive bacteria, such as methicillin-resistant staphylococci and penicillin-resistant Streptococcus pneumoniae (PRSP). The MICs of this compound at which 90% of isolates were inhibited were 2 μg/ml for methicillin-resistant Staphylococcus aureus (MRSA), 2 μg/ml for methicillin-resistant coagulase-negative staphylococci, and 0.031 μg/ml for PRSP. In time-kill studies with six strains of MRSA, ME1036 at four times the MIC caused a time-dependent decrease in the numbers of viable MRSA cells. The activity of ME1036 against MRSA is related to its high affinity for penicillin-binding protein 2a, for which the 50% inhibitory concentration of ME1036 was approximately 300-fold lower than that of imipenem. In conclusion, ME1036 demonstrated a broad antibacterial spectrum and high levels of activity in vitro against staphylococci, including β-lactam-resistant strains.

scholarly journals Incidence and Bacterial Etiologies of Surgical Site Infections in a Public Hospital, Addis Ababa, Ethiopia

2019 ◽  
Vol 13 (1) ◽  
pp. 301-307
Author(s):  
Alem A. Kalayu ◽  
Ketema Diriba ◽  
Chuchu Girma ◽  
Eman Abdella
Keyword(s):  
Drug Resistance ◽  
Addis Ababa ◽  
Surgical Site Infections ◽  
Resistant Bacteria ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Clinical Criteria ◽  
Gram Positive Bacteria

Background: Surgical Site Infections (SSIs) are among the frequently reported healthcare-acquired infections worldwide. Successful treatment of SSIs is affected by the continuous evolvement of drug-resistant microbes. This study investigated the incidence of SSIs, identifying the major etiologic agents and their drug resistance patterns in Yekatit 12 Hospital, Ethiopia. Methods: A cross-sectional study was conducted on 649 patients who underwent surgery at Yekatit 12 hospital from April 2016 to April 2017. Socio-demographic and clinical data were collected from each patient on admission. After surgery, they were followed for SSI occurrence. SSI was initially diagnosed by a senior surgeon based on standard clinical criteria and then confirmed by culture. Isolates were tested for drug resistance according to the clinical and laboratory standards institute guideline. Results: Of the 649 study participants, 56% were females. Their age ranged from 9 months to 88 years with a median age of 37 years. The incidence of culture-confirmed SSI was 10.2% (66/649) where 73 isolates were recovered. About two-third of the isolates were Gram-positive bacteria. Staphylococcus aureus was the most frequently isolated (27/73, 37%) followed by Coagulase-negative staphylococci (18/73, 24.7%), Escherichia coli (11/73, 15.1%) and Klebsiella species (10/73, 13.7%). About 89% and 44% of S. aureus isolates were resistant to penicillin and trimethoprim-sulfamethoxazole, respectively. MRSA constituted 11% of the S. aureus isolates. All the Gram-negative isolates were resistant to ampicillin and trimethoprim-sulfamethoxazole but susceptible to amikacin and meropenem. Klebsiella species showed 70-100% resistance to ceftazidime, cefuroxime, augmentin, chloramphenicol, ciprofloxacin, cefepime and gentamicin. About 82% of E. coli isolates were resistant for chloramphenicol, cefepime, ceftazidime, augmentin, cefuroxime and 64% for gentamicin and ciprofloxacin. Conclusion: The incidence of surgical site infection in Yekatit 12 hospital is 10.2%. Most of the SSIs were due to Gram-positive bacteria. Gram-negative isolates showed high resistance to the most commonly prescribed drugs. No resistance was found for meropenem indicating the absence of carbapenem-resistant bacteria. SSI treatments should be guided by culture and drug resistance test. Better infection prevention practices and continuous surveillance of antimicrobial resistance in the hospital are recommended for better patient care.

scholarly journals ASSESSMENT OF THE ROLE OF CRP AND PLATELET COUNT IN EARLY NEONATAL SEPSIS

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Sachin Walchand Shaha
Keyword(s):  
Platelet Count ◽  
Blood Culture ◽  
Neonatal Intensive Care ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Gram Negative ◽  
Reactive Protein ◽  
Resource Limited ◽  
Group B ◽  
A Prospective Study

Material and Methods: A Prospective study was performed in the department of Pediatrics in territory care institute for the duration of 8 months. Forty newborns were included in the study group to satisfy including criteria. Before antibiotic treatment, neonates CRP and platelet count were assessed. Data were analyzed by SPSS software. Results: Out of the 40 cases, 22 were male babies, and the rest 18 were female. Blood culture was positive in 19 out of the 40 cases, CRP was positive in 21 cases, and thrombocytopenia was observed in 16 cases.  Klebsiella is the commonest gram organism causing sepsis in the Neonatal Intensive Care Unit. The Gram-positive organisms grown are Coagulase Positive and Coagulase-negative Staphylococci, Group B Beta Hemolytic Streptococcus, and Enterococcus. Out of 16 thrombocytopenia neonatal, 15 shows Gram-negative and 1 shows gram-positive blood culture. Conclusion: Qualitative analysis of C-reactive protein can be used as an early marker of sepsis, especially in resource-limited settings. Although thrombocytopenia occurs predominantly in gram-negative sepsis, there is insufficient evidence to support the use of platelet count to differentiate between gram-positive and gram-negative sepsis. Keywords: CRP, Platelet count,blood cultures, sepsis.

scholarly journals Microbiological Isolates and Antibiotic Susceptibilities in Cases of Posttraumatic Endophthalmitis: A 15-Year Review

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Chunhong Liu ◽  
Jian Ji ◽  
Zhujian Wang ◽  
Huiwen Chen ◽  
Wenjun Cao ◽  
...  
Keyword(s):  
Antibiotic Sensitivity ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Fungal Isolates ◽  
Antibiotic Susceptibilities ◽  
Chi Squared ◽  
Posttraumatic Endophthalmitis ◽  
Over Time

Purpose. The objective of this study was to evaluate the microbiological spectrum and antibiotic susceptibilities of isolates in posttraumatic endophthalmitis over a 15-year period. Methods. A retrospective study of 3,163 posttraumatic endophthalmitis cases was conducted between July 2004 and July 2019. The outcome measures included the microbiological spectrum and antibiotic susceptibilities. Chi-squared tests were conducted to detect trends in changes in antibiotic sensitivity over the 15-year period. P values of <0.05 were considered statistically significant. Results. Of the 3,163 cases of posttraumatic endophthalmitis, 1,003 culture-positive isolates were identified. Among these, there were 848 (84.5%) Gram-positive isolates, 109 (10.9%) Gram-negative isolates, and 46 (4.6%) fungal isolates. The most common isolates were Staphylococcal species. There was a significant increase in the percentage of fungal isolates over the 15-year period (P=0.02). Gram-positive organisms showed the greatest level of susceptibility to vancomycin (99.6%). The susceptibilities of the 109 Gram-negative isolated organisms were as follows: levofloxacin (95.8%), meropenem (95.7%), ciprofloxacin (93.5%), tobramycin (90.8%), imipenem (88.9%), trimethoprim-sulfamethoxazole (TMP-SMX) (87.7%), ertapenem (80%), and ceftazidime (79.1%). The susceptibility of Gram-positive organisms to several antibiotics, including levofloxacin (P=0.004), ciprofloxacin (P<0.001), and chloramphenicol (P=0.001) decreased over time, whereas the susceptibility to TMP-SMX increased over time (P<0.001). The susceptibility of Gram-negative bacilli to ceftazidime decreased over time (P=0.03). Conclusions. Over the 15-year study period, most isolates were Gram-positive cocci, especially coagulase-negative staphylococci (CNS). Vancomycin seemed to be the most effective antibiotic for Gram-positive bacteria. Gram-negative bacteria appeared to be most susceptible to fluoroquinolones. A number of antibiotics showed an increasing trend of microbial resistance.

Management of Febrile Neutropenia: Single Agent or Combination Therapy?.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5063-5063 ◽  
Author(s):  
Joana Caldas ◽  
Teresa Fernandes ◽  
Alexandra Monteiro ◽  
Luisa Carande ◽  
Madalena Silva ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Single Agent ◽  
Primary Prophylaxis ◽  
Empirical Treatment ◽  
Success Rates ◽  
Coagulase Negative Staphylococci ◽  
Gram Negative ◽  
Restriction Policy ◽  
Initial Regimen ◽  
Neutropenic Patients

Abstract The best strategy for the empirical treatment of fever in profoundly neutropenic patients (pts) remains unclear. We retrospectively compared the efficacy and safety of 2 antibacterial regimens consecutively used in our center for febrile neutropenia (FN) in pts undergoing intensive chemotherapy for acute leukemia or autologous stem cell transplantation. From 1/99 to 6/01, 374 episodes of FN in 179 pts were treated with piperacillin-tazobactam plus amikacin (PTA, 4.5 g q6h and 20 mg/kg q24h respectively), then from 7/01 to 12/03, 428 episodes in 223 pts were treated with cefepime (CEF, 2g q8h). Any modification of the initial regimen was evaluated as a failure. Pts were nursed in HEPA-filtered rooms and received prophylactic aciclovir (and ciprofloxacin until 12/99) with no antifungal primary prophylaxis. There were no significant differences between the PTA and CEF episodes regarding median age of the pts, median days with neutrophils <500/μl or presence of an intravenous central catheter. The proportion of documented bacteremias was similar (33/30%) with a Gram negative predominance in both periods (60/66%), mainly due to E. coli (61/64%) and P. aeruginosa (14/14%). As for Gram positive bacteremias, there was an increase in S. aureus (18% in PTA vs 27% in CEF) and a marked decrease in S. viridans (24/4%). Resistance of Gram negative bacteria to the protocol drugs remained low (7% to PT and 4% to A in the first period, 5% to CEF in the second); resistance of coagulase negative staphylococci to ciprofloxacin dropped from 33 to 15%. Success rates were 35% for PTA and 32% for CEF. The reasons for modification of the initial empirical regimen were similar in the 2 periods, the most frequent being persistent fever (56/59%) followed by progression of infection (20/18%), relapsing fever (19/14%), withdrawal due to toxicity (3/6%) and resistant pathogen (1/3%). The addition of an antifungal was the most usual modification, occuring in 44% of PTA and 39% of CEF episodes. Vancomycin (for which a restriction policy had been introduced in 1995 after an outbreak of vancomycin-resistant enterococci) was added in 17 and 15% of the episodes. Amikacin was added in 38% of the CEF episodes. The occurence of further infections did not differ between the 2 periods (26 and 29%) nor did the mortality due to infection (7.7 and 6%). The proportion of severe adverse events (CTC-NCI grades 3/4) was low in both periods (4 and 1%). Cutaneous allergic reactions were less frequent with PTA than with CEF (5 vs 9%). We conclude that monotherapy with CEF was as effective as the combination of PTA for empirical treatment of FN. Both regimens resulted in a low infectious mortality and a very low emergence of resistance, and both were well tolerated.

scholarly journals Susceptibility of bacterial endophthalmitis isolates to vancomycin, ceftazidime, and amikacin

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kuan-Jen Chen ◽  
Ming-Hui Sun ◽  
Chiun-Ho Hou ◽  
Hung-Chi Chen ◽  
Yen-Po Chen ◽  
...  
Keyword(s):  
Vision Loss ◽  
Multidrug Resistant ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
In Vitro Susceptibility ◽  
Gram Negative ◽  
Tertiary Referral Center ◽  
Bacterial Endophthalmitis ◽  
Severe Vision Loss

AbstractBacterial endophthalmitis is a rare intraocular infection, and prompt administration of intravitreal antibiotics is crucial for preventing severe vision loss. The retrospective study is to investigate the in vitro susceptibility to the antibiotics vancomycin, amikacin, and ceftazidime of bacterial endophthalmitis isolates in specimens at a tertiary referral center from January 1996 to April 2019 in Taiwan. Overall, 450 (49.9%) isolates were Gram positive, 447 (49.6%) were Gram negative, and 4 (0.4%) were Gram variable. In Gram-positive isolates, coagulase-negative staphylococci were the most commonly cultured bacteria (158, 35.1%), followed by Streptococci (100, 22.2%), Enterococci (75, 16.7%), and Staphylococcus aureus (70, 15.6%). In Gram-negative isolates, they were Klebsiella pneumoniae (166, 37.1%) and Pseudomonas aeruginosa (131, 29.3%). All Gram-positive organisms were susceptible to vancomycin, with the exception of one Enterococcus faecium isolate (1/450, 0.2%). Of the Gram-negative isolates, 96.9% and 93.7% were susceptible to ceftazidime and amikacin, respectively. Nine isolates (9/447, 2.0%) were multidrug-resistant Gram-negative bacteria, comprising K. pneumoniae (4/164, 2.4%), Acinetobacter baumannii (2/3, 67%), and Stenotrophomonas maltophilia (3/18, 17%). In conclusion, in vitro susceptibility testing revealed that vancomycin remains the suitable antibiotic treatment for Gram-positive endophthalmitis. Ceftazidime and amikacin provide approximately the same degree of Gram-negative coverage. Multidrug-resistant bacterial endophthalmitis was uncommon.

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