Pseudomonas aeruginosa Endophthalmitis: Clinical Outcomes and Antibiotic Susceptibilities.

Purpose: To report the clinical characteristics, antibiotic susceptibilities, and visual outcomes for eyes with endophthalmitis caused by Pseudomonas aeruginosa.

Methods: In this retrospective, non-comparative case series, medical records of eyes with culture-proven Pseudomonas aeruginosa endophthalmitis, who were treated from April 2005 to April 2015 at a referral center in Tehran were reviewed. Clinical features, antibiotic susceptibilities, and visual outcomes were assessed.

Results: In total, 20 eyes of 19 patients were identified. The clinical settings included cataract surgery (85%), pars plana vitrectomy (5%), endogenous source (5%), and intravitreal bevacizumab injection (5%). Presenting visual acuity ranged from 20/120 to no light perception. Pars plana vitrectomy with intravitreal antibiotic injection was performed as the initial treatment in 16 eyes (80%). The organisms were sensitive to ciprofloxacin and imipenem in 100%; amikacin in 88.3%; ceftazidime in 83.4%; and tobramycin in 83.4% of isolates tested. Final visual acuity was hand motions or worse in 18 eyes (90%). Evisceration was performed in five eyes (20%).

Conclusions: Susceptibility to ciprofloxacin and imipenem was found in all isolates tested. Despite appropriate treatment, visual and anatomic outcomes were generally poor.