# Clinical Profile, Antibiotic Resistance and Outcomes in Bacterial Endophthalmitis: Coagulase-Negative Staphylococcus Endophthalmitis as Compared to Other Organisms

## TL;DR

This study compares outcomes and antibiotic resistance in eye infections caused by coagulase-negative Staphylococcus versus other bacteria, finding better visual results with the former.

## Contribution

The study provides new clinical insights into bacterial endophthalmitis outcomes and antibiotic resistance patterns specific to coagulase-negative Staphylococcus.

## Key findings

- Eyes infected with coagulase-negative Staphylococcus had better visual outcomes compared to those with other bacteria.
- Group 2 isolates showed higher antibiotic resistance and more severe clinical features like retinal detachment.
- Pseudomonas in group 2 showed high resistance to ceftazidime and cefazolin.

## Abstract

Background: To evaluate the clinical profile, outcomes and antibiotic resistance in bacterial endophthalmitis.

Methods: This was a post-hoc analysis of a study conducted at a tertiary centre, where 60 consecutive cases of culture-proven bacterial endophthalmitis were included prospectively. Group 1 included coagulase-negative Staphylococcus endophthalmitis (CNSE), while group 2 included the remaining cases. Clinical features, antibiotic resistance and visual outcomes were compared. Visual acuity >3/60 at six months of follow-up was defined as a good visual outcome.

Results: Group 1 had 31 cases, while group 2 had 29. Group 2 included 12 gram-positive and 17 gram-negative isolates. Among the groups, group 2 had more patients with presenting visual acuity below hand motions close to the face (25 vs. 12, p<0.001), poor visual outcomes (26 vs. 3, p<0.001) and retinal detachment (RD) (10 vs. 2, p=0.007). Pseudomonas was most commonly resistant to antibiotics, and ceftazidime (p=0.005) and cefazolin (p=0.009) resistance were higher in group 2 isolates. In group 1, five isolates were resistant to any one of the antibiotics, whereas in group 2, 13 isolates were resistant to any one of the antibiotics (p=0.024).

Conclusions: In the current study, eyes in the group of endophthalmitis caused by CNSE achieved better visual acuities at the last follow-up compared to eyes with endophthalmitis caused by other bacteria. Antibiotic resistance in isolates other than CNSE is a cause of concern.