Kato Juliana Mika, Tanaka Tatiana, de Oliveira Luiza Manhezi Shin, de Oliveira Maura Salaroli, Rossi Flavia, Goldbaum Mauro, Pimentel Sergio Luis Gianotti, de Almeida Junior João Nóbrega, Yamamoto Joyce Hisae
Department of Ophthalmology-LIM33, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, 255 Av. Dr. Enéas Carvalho de Aguiar, São Paulo, Brazil.
Division of Infectious and Parasitic Diseases, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Int J Retina Vitreous. 2021 Feb 16;7(1):14. doi: 10.1186/s40942-021-00280-1.
Acute post-cataract endophthalmitis (APE) is a rare complication potentially causing irreversible visual loss. A 10-year study of APE was conducted to determine its incidence, microbiological spectra and antibiotic resistance profile of APE-related pathogens at a major tertiary referral center in Brazil.
APE cases reported between January 2010 and December 2019 were included. Phacoemulsification and extracapsular cataract techniques were eligible; combined procedures, traumatic and congenital cataract were excluded. Vitreous samples were cultured and antimicrobial resistance was compared for the periods of 2010-2014 and 2015-2019. The results were analyzed with Fisher's exact test.
Our sample consisted of 40,491 cataract surgeries and 51 (0.126%) APE cases. Culture was positive in 35 cases (71.4%), of which 31 (88.6%) Gram-positive, 3 (8.6%) Gram-negative, and 1 (2.9%) fungal. The most frequently isolated organism was Staphylococcus epidermidis (n = 17/35, 48.6%), followed by Staphylococcus aureus (n = 4/35, 11.4%). From 2010-2014 to 2015-2019, antimicrobial resistance increased against moxifloxacin (11.1-54.5%, p = 0.07), ciprofloxacin (54.5-72.7%, p = 0.659) and oxacillin (66.7-93.3%, p = 0.13).
The observed incidence and microbial spectra were compatible with previous studies. A trend towards growing moxifloxacin and ciprofloxacin resistance was observed. Surveillance remains crucial to prevent treatment failure from antimicrobial resistance.
白内障术后急性眼内炎（APE）是一种罕见的并发症，可能导致不可逆的视力丧失。在巴西一家主要的三级转诊中心进行了一项为期10年的APE研究，以确定其发病率、微生物谱以及APE相关病原体的抗生素耐药性特征。
纳入2010年1月至2019年12月期间报告的APE病例。超声乳化白内障吸除术和囊外白内障摘除术符合条件；联合手术、外伤性和先天性白内障被排除。对玻璃体样本进行培养，并比较2010 - 2014年和2015 - 2019年期间的抗菌药物耐药性。结果采用Fisher精确检验进行分析。
我们的样本包括40491例白内障手术和51例（0.126%）APE病例。35例（71.4%）培养结果为阳性，其中31例（88.6%）为革兰氏阳性菌，3例（8.6%）为革兰氏阴性菌，1例（2.9%）为真菌。最常分离出的微生物是表皮葡萄球菌（n = 17/35，48.6%），其次是金黄色葡萄球菌（n = 4/35，11.4%）。从2010 - 2014年到2叭5 - 2019年，对莫西沙星的耐药性增加（11.1 - 54.5%，p = 0.07），对环丙沙星的耐药性增加（54.5 - 72.7%，p = 0.659），对苯唑西林的耐药性增加（66.7 - 93.3%，p = 0.13）。
观察到的发病率和微生物谱与先前的研究一致。观察到对莫西沙星和环丙沙星耐药性增加的趋势。监测对于预防抗菌药物耐药导致的治疗失败仍然至关重要。
