Clinical features, microbiological profile and treatment outcome of patients with Corynebacterium endophthalmitis: review of a decade from a tertiary eye care centre in southern India

Br J Ophthalmol. 2016 Feb;100(2):189-94. doi: 10.1136/bjophthalmol-2015-306910. Epub 2015 Jun 29.

Abstract

Aims: To report the clinical and microbiological profile along with treatment outcome of patients with endophthalmitis caused by Corynebacterium sp.

Methods: This is a retrospective, consecutive, non-comparative case series of patients with culture-proven Corynebacterium endophthalmitis seen between August 2004 and July 2014.

Results: Of 5439 patients clinically diagnosed as infective endophthalmitis, vitreous samples were culture positive for bacteria in 1488 (27%). Sixteen patients (1%) were identified as Corynebacterium endophthalmitis. The clinical settings included trauma (n=10), post-cataract surgery (n=5) and post-penetrating keratoplasty (n=1). In 7/16 (44%) patients, the organisms were visualised in direct microscopy. Tested by disc-diffusion method, all isolates were vancomycin sensitive. However, 9 of 10 isolates were resistant to ceftazidime and 5 of 14 isolates were resistant to amikacin. Initial treatment strategies included pars plana vitrectomy with intravitreal antibiotics (vancomycin and amikacin/ceftazidime) injection (n=9) and pars plana lensectomy along with pars plana vitrectomy and intravitreal antibiotics (vancomycin and amikacin/ceftazidime) injection (n=7). Final visual acuity was 20/200 or better in 11 (69%) of 16 patients.

Conclusions: The prevalence of corynebacterial endophthalmitis is low. The organisms are susceptible to vancomycin, and early appropriate treatment results in favourable outcome.

Keywords: Infection; Microbiology; Retina; Treatment Medical; Vitreous.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Child, Preschool
  • Corynebacterium / drug effects
  • Corynebacterium / isolation & purification*
  • Corynebacterium Infections* / diagnosis
  • Corynebacterium Infections* / drug therapy
  • Corynebacterium Infections* / microbiology
  • Drug Resistance, Bacterial
  • Endophthalmitis* / diagnosis
  • Endophthalmitis* / drug therapy
  • Endophthalmitis* / microbiology
  • Eye Infections, Bacterial* / diagnosis
  • Eye Infections, Bacterial* / drug therapy
  • Eye Infections, Bacterial* / microbiology
  • Female
  • Humans
  • India
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Tertiary Care Centers
  • Treatment Outcome
  • Vancomycin / pharmacology
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Vancomycin