Skip to main content
Log in

Emergence of Enterococcus species in the infectious microorganisms cultured from patients with endophthalmitis in South Korea

  • Clinical and Epidemiological Study
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Purpose

To investigate the microorganisms in culture-proven endophthalmitis and their susceptibilities to antimicrobial agents commonly used in South Korea.

Methods

Medical records of consecutive patients with culture-proven endophthalmitis at eight institutions between 1 January 2004 and 31 July 31 2010 were reviewed. Four categories of endophthalmitis were studied: postoperative, posttraumatic, endogenous, and unspecified. Outcome measures were culture-proven infectious organisms, antimicrobial susceptibilities, and final visual acuity in the patients.

Results

A total of 93 microorganisms were identified from 103 patients during the study period. The positive culture rate was 59.2 % (103/174). The most common organisms identified were Enterococcus faecalis (in 20.8 % of patients, 20/96), Staphylococcus epidermidis (18.8 %, 18/96), other coagulase-negative staphylococci (10.4 %, 10/96), Pseudomonas aeruginosa (6.3 %, 6/96), and Klebsiella pneumoniae (6.3 %, 6/96). Two cases of Enterococcus faecium (2.1 %) were recognized. Overall, 70 of 96 (73.0 %) isolates were Gram-positive bacteria, 22 (23.0 %) were Gram-negative bacteria, and 4 (4.2 %) were fungi. The most common organisms resulting in reduced light perception were E. faecalis and K. pneumoniae.

Conclusions

The emergence of E. faecalis in endophthalmitis is mainly caused by the high incidence of E. faecalis in postoperative endophthalmitis. This increase also impacts the final visual acuity of the patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Mamalis N. Endophthalmitis. J Cataract Refract Surg. 2002;28:729–30.

    Article  PubMed  Google Scholar 

  2. [No Authors Listed]. Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Endophthalmitis Vitrectomy Study Group. Arch Ophthalmol. 1995;113:1479–96.

    Google Scholar 

  3. Kattan HM, Flynn HW Jr, Pflugfelder SC, Robertson C, Forster RK. Nosocomial endophthalmitis survey: current incidence of infection after intraocular surgery. Ophthalmology. 1991;98:227–38.

    Article  CAS  PubMed  Google Scholar 

  4. Aaberg TM Jr, Flynn HW Jr, Schiffman J, Newton J. Nosocomial acute-onset postoperative endophthalmitis survey: a 10-year review of incidence and outcomes. Ophthalmology. 1998;105:1004–10.

    Article  PubMed  Google Scholar 

  5. Taban M, Behrens A, Newcomb RL, Nobe MY, Saedi G, Sweet PM, et al. Acute endophthalmitis following cataract surgery: a systematic review of the literature. Arch Ophthalmol. 2005;123:613–20.

    Article  PubMed  Google Scholar 

  6. [No Authors Listed]. Microbiologic factors and visual outcome in the Endophthalmitis Vitrectomy Study. Am J Ophthalmol. 1996;122:830–846.

    Google Scholar 

  7. Benz MS, Scott IU, Flynn HW Jr, Unonius N, Miller D. Endophthalmitis isolates and antibiotic sensitivities: a 6-year review of culture-proven cases. Am J Ophthalmol. 2004;137:38–42.

    Article  PubMed  Google Scholar 

  8. Pijl BJ, Theelen T, Tilanus MA, Rentenaar R, Crama N. Acute endophthalmitis after cataract surgery: 250 consecutive cases treated at a tertiary referral center in the Netherlands. Am J Ophthalmol. 2010;149:482–7.

    Article  PubMed  Google Scholar 

  9. Choi S, Hahn TW, Osterhout G, O’Brien TP. Comparative intravitreal antibiotic therapy for experimental Enterococcus faecalis endophthalmitis. Arch Ophthalmol. 1996;114:61–5.

    Article  CAS  PubMed  Google Scholar 

  10. Han DP, Wisniewski SR, Wilson LA, Barza M, Vine AK, Doft BH, et al. Spectrum and susceptibilities of microbiologic isolates in the Endophthalmitis Vitrectomy Study. Am J Ophthalmol. 1996;122:1–17.

    CAS  PubMed  Google Scholar 

  11. Chen KJ, Lai CC, Sun MH, Chen TL, Yang KJ, Kuo YH, et al. Postcataract endophthalmitis caused by Enterococcus faecalis. Ocul Immunol Inflamm. 2009;17:364–9.

    Article  PubMed  Google Scholar 

  12. Scott IU, Loo RH, Flynn HW Jr, Miller D. Endophthalmitis caused by Enterococcus faecalis: antibiotic selection and treatment outcomes. Ophthalmology. 2003;110:1573–7.

    Article  PubMed  Google Scholar 

  13. Struelens MJ. The epidemiology of antimicrobial resistance in hospital acquired infections: problems and possible solutions. BMJ. 1998;317:652–4.

    Article  CAS  PubMed  Google Scholar 

  14. Callegan MC, Ramirez R, Kane ST, Cochran DC, Jensen H. Antibacterial activity of the fourth-generation fluoroquinolones gatifloxacin and moxifloxacin against ocular pathogens. Adv Ther. 2003;20:246–52.

    Article  CAS  PubMed  Google Scholar 

  15. Rishi E, Rishi P, Nandi K, Shroff D, Therese KL. Endophthalmitis caused by Enterococcus faecalis: a case series. Retina. 2009;29:214–7.

    Article  PubMed  Google Scholar 

  16. Clinical and Laboratory Standards Institute (CLSI). Clinical and Laboratory Standards Institute document. CLSI, Wayne, Pa.; 2005.

  17. Kunimoto DY, Das T, Sharma S, Jalali S, Majji AB, Gopinathan U, et al. Microbiologic spectrum and susceptibility of isolates: part I. Postoperative endophthalmitis. Endophthalmitis Research Group. Am J Ophthalmol. 1999;128:240–2.

    Article  CAS  PubMed  Google Scholar 

  18. Park SH, Lim JA, Choi JS, Kim KA, Joo CK. The resistance patterns of normal ocular bacterial flora to 4 fluoroquinolone antibiotics. Cornea. 2009;28:68–72.

    Article  PubMed  Google Scholar 

  19. Friling E, Lundstrom M, Stenevi U, Montan P. Six-year incidence of endophthalmitis after cataract surgery: Swedish national study. J Cataract Refract Surg. 2013;39:15–21.

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This work was supported by the 2013 Inje University research grant.

Conflict of interest

No conflicting relationships exist for any authors.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S. J. Lee.

Additional information

H.W. Kim, S.Y. Kim, and I.Y. Chung contributed equally to this work.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 15 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, H.W., Kim, S.Y., Chung, I.Y. et al. Emergence of Enterococcus species in the infectious microorganisms cultured from patients with endophthalmitis in South Korea. Infection 42, 113–118 (2014). https://doi.org/10.1007/s15010-013-0530-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-013-0530-z

Keywords

Navigation