J Korean Ophthalmol Soc.  2017 Jun;58(6):663-669. 10.3341/jkos.2017.58.6.663.

Endophthalmitis Caused by Stenotrophomonas maltophilia after Cataract Surgery: Clinical Features, Antibiotic Sensitivities, and Outcomes

Affiliations
  • 1Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea. chojoo@kimeye.com

Abstract

PURPOSE
To describe the clinical manifestations, treatment results, and antibiotic susceptibility in 6 cases of Stenotrophomonas maltophilia endophthalmitis.
METHODS
We retrospectively reviewed 6 eyes of 6 patients who were diagnosed with Stenotrophomonas maltophilia endophthalmitis. Specifically, we considered each patient's age, sex, past history, visual acuity, hypopyon, treatment, and prognosis.
RESULTS
For our study, we considered patients treated during the period of January 2008 to December 2015. Stenotrophomonas maltophilia (6 eyes) was the second most common gram-negative bacteria cause of total bacterial endophthalmitis while Pseudomonas aeruginosa (14 eyes) was the most common gram-negative bacteria cause during the same period. Visual disturbance was the dominant symptom being found in all 6 patients. Other symptoms include ocular pain and hypopyon. The initial visual acuity was light perception (1 patient), hand motion (3 patients), finger count (1 patient), and 0.02 (1 patient). Excluding the 1 patient with light perception, the mean initial visual acuity was logMAR 1.72 (Snellen equivalent; 20/1,049). Overall, 5 patients underwent vitrectomy and intravitreal antibiotics injection, while, the remaining other patient was treated with intravitreal antibiotics injection, followed by vitrectomy. All 6 patients showed sensitivity to Ceftazidime and Levofloxacin and 2 patients showed sensitivity to Trimethoprim/Sulfamethoxazole.
CONCLUSIONS
Stenotrophomonas maltophilia endophthalmitis was the second most common gram negative organism to cause endophthalmitis after cataract surgery. All 6 of the tested isolates were found to be sensitive to ceftazidime and levofloxacin. Urgent treatment outcomes were similar to previous reports.

Keyword

Endophthalmitis; Stenotrophomonas maltophilia

MeSH Terms

Anti-Bacterial Agents
Cataract*
Ceftazidime
Endophthalmitis*
Fingers
Gram-Negative Bacteria
Hand
Humans
Levofloxacin
Prognosis
Pseudomonas aeruginosa
Retrospective Studies
Stenotrophomonas maltophilia*
Stenotrophomonas*
Visual Acuity
Vitrectomy
Anti-Bacterial Agents
Ceftazidime

Figure

  • Figure 1 Slit lamp photo of case 5. At the time of admission for first vitrectomy, slit lamp photo shows corneal edema and hypopyon.

  • Figure 2 Fundus photo of case 2. At the time of admission for first vitrectomy, fundus photo shows hazy view due to vitreous opacity.


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