To determine the type of bacteria and the visual outcome of culture-proven multidrug-resistant bacterial endophthalmitis
in patients at a tertiary eye care center in southern India.
This is a retrospective case series in which clinical and microbiologic records of culture-proven bacterial endophthalmitis
between January 2000 and December 2007 were reviewed. Multidrug resistance was defined as resistance to two or more different groups of typically susceptible classes of antibiotics.
Of 807 patients, vitreous from 42 patients (5.2%) yielded multidrug-resistant bacteria in culture. Thirty-two (71%) of these patients had a poor visual outcome (31.6% in non–multidrug-resistant group). Multidrug resistance was more common in gram-negative bacteria (33; 78.6%) compared with gram-positive bacteria (9; 21.4%). Pseudomonas
spp. (24 isolates) were the most common isolated bacteria. Fifteen (45%) of the 33 gram-negative isolates were resistant to ceftazidime, 18 (54.5%) were resistant to amikacin, and 11 (33.3%) were resistant to both amikacin and ceftazidime. Five (55.56%) of the 9 gram-positive isolates were resistant to vancomycin.
Gram-negative bacteria, chiefly Pseudomonas
, are the most common multidrug-resistant organisms, and the outcome is usually poor. Emergence of multidrug-resistant bacteria is a matter of concern. A new alternative group of drugs may be considered for the management of these isolated cases.