Sridhar Jayanth, Kuriyan Ajay E, Flynn Harry W, Smiddy William E, Venincasa Vincent D, Miller Darlene
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
Retina. 2015 Jun;35(6):1095-100. doi: 10.1097/IAE.0000000000000509.
To report the clinical features, antibiotic sensitivities, and visual outcomes associated with endophthalmitis caused by Serratia marcescens.
A consecutive case series of patients with vitreous culture-positive endophthalmitis caused by S. marcescens from July 1, 1993, to June 30, 2012, at a large university referral center. Findings from this study were compared with those of a previous study (January 1980-June 1993) from our institution.
Of the 10 study patients who were identified, clinical settings included trabeculectomy bleb-associated (n = 3), post-cataract surgery (n = 2), post-penetrating keratoplasty (n = 2), post-scleral buckle (n = 1), glaucoma drainage implant-associated (n = 1), and post-keratoprosthesis (n = 1). Clinical features included pain (n = 10) and hypopyon (n = 5). Presenting visual acuity was hand motions or worse in seven cases. All isolates were sensitive to gentamicin, ceftazidime, imipenem, and levofloxacin. The MIC 90s of isolates for antibiotics tested in the current period compared with isolates from January 1980 to June 1993 were unchanged. All isolates were resistant to vancomycin. Initial treatment strategies were vitreous tap and intravitreal antibiotic injection (n = 8), pars plana vitrectomy with intravitreal antibiotic injection (n = 1), and evisceration (n = 1). When repeat vitreous fluid was obtained, persistent positive cultures were present in 1 (10%) of 10 patients in this study, compared with 5 (50%) of 10 patients in the previous study. Final visual acuity was no light perception in 6 of 10 patients (60%).
Outcomes were generally poor with a high rate of complete visual loss in the affected eye.
报告由粘质沙雷氏菌引起的眼内炎的临床特征、抗生素敏感性及视力转归。
对1993年7月1日至2012年6月30日期间在一所大型大学转诊中心确诊的、玻璃体培养阳性的粘质沙雷氏菌所致眼内炎患者进行连续病例系列研究。本研究结果与本机构之前一项研究（1980年1月至1993年6月）的结果进行比较。
在确诊的10例研究患者中，临床情况包括小梁切除术滤过泡相关（3例）、白内障术后（2例）、穿透性角膜移植术后（2例）、巩膜扣带术后（1例）、青光眼引流植入物相关（1例）及角膜移植术后（1例）。临床特征包括疼痛（10例）和前房积脓（5例）。7例患者就诊时视力为手动或更差。所有分离菌株对庆大霉素、头孢他啶、亚胺培南和左氧氟沙星敏感。与1980年1月至1993年6月的分离菌株相比，本期检测的抗生素对分离菌株的MIC90未发生变化。所有分离菌株对万古霉素耐药。初始治疗策略为玻璃体穿刺和玻璃体内注射抗生素（8例）、玻璃体切割联合玻璃体内注射抗生素（1例）和眼球摘除术（1例）。当再次获取玻璃体液时，本研究10例患者中有1例（10%）培养持续阳性，而之前的研究10例患者中有5例（50%）培养持续阳性。10例患者中有6例（60%）最终视力为无光感。
总体预后较差，患眼完全失明率较高。
