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Microbiological trends and drug sensitivity patterns in endophthalmitis in eastern India

Session Details

Session Title: Miscellaneous

Session Date/Time: Saturday 13/09/2014 | 11:00-13:00

Paper Time: 11:56

Venue: Boulevard E

First Author: : S.Das INDIA

Co Author(s): :    R. Roy   S. Pal           

Abstract Details

Purpose:

To analyse the microbiological trends and drug sensitivity patterns of endophthalmitis cases in a tertiary centre in Eastern India

Setting:

Aditya Birla Sankara Nethralaya, Kolkata

Methods:

Single centre, retrospective, interventional consecutive case series of 162 endophthalmitis eyes of 162 patients presenting between January 2008 to December 2012 .Aqueous or vitreous aspirate obtained in each case was sent for Gram staining , KOH mount, Bacterial and fungal culture followed by drug sensitivity. Polymerase Chain Reaction (PCR) was done for Eubacterial genome, Propionibactum acnes and panfungal genome. Endophthalmitis Vitrectomy Study (EVS) guidelines were followed for surgery

Results:

Mean age of presentation was 47.45 ± 23.27 yrs with a mean follow up of 5.6 months. Postoperative cases were 73% followed by traumatic 19% and endogenous 8% patients. Infection after cataract surgery was 89% in postoperative condition. Gram positive bacteria were seen in 52% cases out of 22.3% smear positive reports. 71% cases were positive for Eubacterial genome out of 85.1% of positive PCR reports. Culture was positive in 34.5% patients out of which gram negative bacteria were isolated in 30.1% cases followed by 18.1% gram positive and 8.5% fungus. There was no growth in 65% cases. Bacillus species was the most common in gram positive group (14.2%) and Pseudomonas was most commonly isolated (14.2%) in gram negative group. Vancomycin had the highest sensitivity (93.4%) amongst gram positive group and Ciprofloxacin (82.6%) in the gram negative group. Ceftazidime resistance was noted in 37.5% of gram positive and 62.5% gram negative infection cases

Conclusions:

In endophthalmitis PCR is a very sensitive tool to diagnose type of infection. There is emergence of gram negative organisms as predominant pathogen along with preponderance of atypical pathogens in this part of the country. Though Vancomycin still holds good for gram positive organism there is an alarming increase in resistance to Ceftazidime amongst gram negative organisms

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