{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T01:14:45Z","timestamp":1780362885937,"version":"3.54.1"},"reference-count":36,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T00:00:00Z","timestamp":1623801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Coagulase-negative staphylococci (CoNS) are frequently occurring ocular opportunistic pathogens that are not easily identifiable to the species level. The goal of this study was to speciate CoNS and document antibiotic susceptibilities from cases of endophthalmitis (n = 50), keratitis (n = 50), and conjunctivitis\/blepharitis (n = 50) for empiric therapy. All 150 isolates of CoNS were speciated using (1) API Staph (biochemical system), (2) Biolog GEN III Microplates (phenotypic substrate system), and (3) DNA sequencing of the sodA gene. Disk diffusion antibiotic susceptibilities for topical and intravitreal treatment were determined based on serum standards. CoNS identification to the species level by all three methods indicated that S. epidermidis was the predominant species of CoNS isolated from cases of endophthalmitis (84\u201390%), keratitis (80\u201386%), and conjunctivitis\/blepharitis (62\u201368%). Identifications indicated different distributions of CoNS species among endophthalmitis (6), keratitis (10), and conjunctivitis\/blepharitis (13). Antibiotic susceptibility profiles support empiric treatment of endophthalmitis with vancomycin, and keratitis treatment with cefazolin or vancomycin. There was no clear antibiotic choice for conjunctivitis\/blepharitis. S. epidermidis was the most frequently found CoNS ocular pathogen, and infection by other CoNS appears to be less specific and random. Antibiotic resistance does not appear to be a serious problem associated with CoNS.<\/jats:p>","DOI":"10.3390\/antibiotics10060721","type":"journal-article","created":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T10:27:07Z","timestamp":1623839227000},"page":"721","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Speciation and Antibiotic Susceptibilities of Coagulase Negative Staphylococci Isolated from Ocular Infections"],"prefix":"10.3390","volume":"10","author":[{"given":"John E.","family":"Romanowski","sequence":"first","affiliation":[{"name":"The Charles T. Campbell Ophthalmic Microbiology Laboratory, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon V.","family":"Nayyar","sequence":"additional","affiliation":[{"name":"The Charles T. Campbell Ophthalmic Microbiology Laboratory, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4246-3276","authenticated-orcid":false,"given":"Eric G.","family":"Romanowski","sequence":"additional","affiliation":[{"name":"The Charles T. Campbell Ophthalmic Microbiology Laboratory, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Jhanji","sequence":"additional","affiliation":[{"name":"The Charles T. Campbell Ophthalmic Microbiology Laboratory, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M. Q.","family":"Shanks","sequence":"additional","affiliation":[{"name":"The Charles T. Campbell Ophthalmic Microbiology Laboratory, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8558-0782","authenticated-orcid":false,"given":"Regis P.","family":"Kowalski","sequence":"additional","affiliation":[{"name":"The Charles T. Campbell Ophthalmic Microbiology Laboratory, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Jorgensen, J.H., Carroll, K.C., Funke, G., Pfaller, M.A., Landry, M.L., Richter, S.S., and Warnock, D.W. (2015). Staphylococcus, Micrococcus, and Other Catalase-Positive Cocci. Manual of Clinical Microbiology, ASM Press. [11th ed.].","DOI":"10.1128\/9781555817381"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1128\/CMR.00109-13","article-title":"Coagulase-negative staphylococci","volume":"27","author":"Becker","year":"2014","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_3","unstructured":"Tasman, W., and Jaeger, E.A. (1998). Normal flora of the human conjunctiva and eyelid. Duane\u2019s Foundations of Clinical Ophthalmology, Lippincott Williams & Wilkins. Chapter 41."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/ICL.0000000000000642","article-title":"The prevalence of bacteria, fungi, viruses, and acanthamoeba from 3004 cases of keratitis, endophthalmitis, and conjunctivitis","volume":"46","author":"Kowalski","year":"2020","journal-title":"Eye Contact Lens"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/S0161-6420(93)31584-8","article-title":"Endophthalmitis caused by the coagulase-negative staphylococci. 1. Disease spectrum and outcome","volume":"100","author":"Ormerod","year":"1993","journal-title":"Ophthalmology"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kaliamurthy, J., Kalavathy, C.M., Parmar, P., and Thomas, P.A.J. (2013). Spectrum of bacterial keratitis at a tertiary eye clinic centre in India. BioMed Res. Int., 181564.","DOI":"10.1155\/2013\/181564"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1136\/bjo.83.7.771","article-title":"Identification and antibiotic susceptibility of coagulase negative staphylococci isolated in corneal\/external infections","volume":"83","author":"Pinna","year":"1999","journal-title":"Br. J. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"59","DOI":"10.4103\/0301-4738.15288","article-title":"Speciation of coagulase negative staphylococcus causing bacterial keratitis","volume":"53","author":"Manikandan","year":"2005","journal-title":"Indian J. Ophthalmol."},{"key":"ref_9","unstructured":"Albert, D.M., and Jakobiec, F.A. (2000). Bacterial infections of the conjunctiva and cornea. Principles and Practices of Ophthalmology, WB Saunders."},{"key":"ref_10","first-page":"793","article-title":"Coagulase-negative staphylococci in normal and chronically inflamed conjunctiva","volume":"92","author":"Grasbon","year":"1995","journal-title":"Ophthalmologe"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1111\/j.1471-0528.1966.tb06127.x","article-title":"Epidemic conjunctivitis in the newborn associated with coagulase negative staphylococci","volume":"73","author":"Hurley","year":"1966","journal-title":"J. Obstet. Gynaecol. Br. Cwith."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1097\/00006324-199804000-00022","article-title":"Identification and enumeration of staphylococci from the eye during soft contact len wear","volume":"75","author":"Leitch","year":"1998","journal-title":"Optom. Vis. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s12941-016-0158-9","article-title":"Comparison of methods for the identification of microorganisms isolated from blood cultures","volume":"15","author":"Monteiro","year":"2016","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1001\/archopht.126.4.554","article-title":"Treatment of postcataract extraction endophthalmitis: A summary of the results from the Endophthalmitis Vitrectomy Study","volume":"126","author":"Doft","year":"2008","journal-title":"Arch. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1159\/000486145","article-title":"2018 Update on intravitreal injections: Euretina expert consensus recommendations","volume":"239","author":"Grzybowski","year":"2018","journal-title":"Ophthalmologica"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/ICU.0000000000000437","article-title":"The use of povidone-iodine in ophthalmology","volume":"29","author":"Grzybowski","year":"2018","journal-title":"Curr. Opin. Ophthalmol"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12348-014-0022-z","article-title":"Pharmacokinetics of intravitreal antibiotics in endophthalmitis","volume":"4","author":"Radhika","year":"2014","journal-title":"J. Ophthalmic. Inflamm. Infect."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1007\/s40135-019-00206-z","article-title":"MRSA keratitis and conjunctivitis: What does it mean practically?","volume":"7","author":"Thareja","year":"2019","journal-title":"Curr. Ophthalmol. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.ajo.2020.03.017","article-title":"Methicillin-resistant Staphylococci aureus keratitis: Initial treatment, risk factors, clinical features, and treatment outcomes","volume":"214","author":"Durrani","year":"2020","journal-title":"Am. J. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1586\/eop.13.7","article-title":"Perspective: Is Antibiotic Resistance a Problem in the Treatment of Ophthalmic Infections?","volume":"8","author":"Kowalski","year":"2013","journal-title":"Exp. Rev. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1089\/jop.2013.0040","article-title":"Antibiotic susceptibility of staphylococci isolates from patients with chronic conjunctivitis: Including associated factors and clinical evaluation","volume":"29","author":"Blanco","year":"2013","journal-title":"J. Ocul. Pharm. Thera"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"15","DOI":"10.2147\/OPTO.S189115","article-title":"Antibiotic resistance among ocular pathogens: Current trends from the ARMOR surveillance study (2009\u20132016)","volume":"11","author":"Thomas","year":"2019","journal-title":"Clin. Optom."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2372","DOI":"10.1128\/AAC.49.6.2372-2377.2005","article-title":"Cellular uptake and efflux of azithromycin, erythromycin, clarithromycin, telithromycin, and cethromycin","volume":"49","author":"Bosnar","year":"2005","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3788","DOI":"10.1128\/AAC.01828-10","article-title":"A novel cell-associated protection assay (CAPA) demonstrates the ability of certain antibiotics to protect ocular surface cell lines from subsequent clinical Staphylococcus aureus challenge","volume":"55","author":"Wingard","year":"2011","journal-title":"Antimicrob. Agents Chemother"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1089\/jop.2010.0097","article-title":"AzaSite\u00ae Inhibits Staphylococcus aureus and Coagulase Negative Staphylococcus Biofilm Formation in vitro","volume":"26","author":"Wu","year":"2010","journal-title":"J. Ocul. Pharm. Ther."},{"key":"ref_26","first-page":"2","article-title":"Anti-inflammatory effects of erythromycin and tetracycline on Propionibacterium acnes induced production of chemotactic factors and reactive oxygen species by human neutrophils","volume":"8","author":"Jain","year":"2002","journal-title":"Derm. Online J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1093\/jac\/dkh519","article-title":"Anti-inflammatory effects of macrolides\u2013an underappreciated benefit in the treatment of community-acquired respiratory tract infections and chronic inflammatory pulmonary conditions?","volume":"55","author":"Amsden","year":"2005","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1128\/AAC.48.5.1581-1585.2004","article-title":"Molecular mechanisms of anti-inflammatory action of erythromycin in human bronchial epithelial cells: Possible role in the signaling pathway that regulates nuclear factor-\u0138B activation","volume":"48","author":"Desaki","year":"2004","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"LaCroce, S., Wilson, M.N., Romanowski, J.E., Newman, J.D., Jhanji, V., Shanks, R.M.Q., and Kowalski, R.P. (2019). Moraxella nonliquefaciens and M. osloensis are Important Moraxella Species that Cause Ocular Infections. Microorganisms, 7.","DOI":"10.3390\/microorganisms7060163"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1111\/j.1469-0691.2009.03036.x","article-title":"Identification of clinical coagulase-negative staphylococci, isolated in microbiology laboratories, by matrix-assisted laser desorption\/ionization-time of flight mass spectrometry and two automated systems","volume":"16","author":"Dupont","year":"2010","journal-title":"Clin. Microbiol. Infect"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/OPX.0000000000000105","article-title":"Corneal inflammatory events with daily silicone hydrogel lens wear","volume":"91","author":"Jiang","year":"2014","journal-title":"Optom. Vis. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1006\/exer.1996.0182","article-title":"Fibronection concentration in tears of contact lens wearers","volume":"64","author":"Fukada","year":"1997","journal-title":"Exp. Eye Res."},{"key":"ref_33","unstructured":"CLSI (2009). Clinical and Laboratory Standards: Performance Standards for Antimicrobial Disk Susceptibility Tests, Clinical and Laboratory Standards Institute. [10th ed.]. Number 1."},{"key":"ref_34","unstructured":"CLSI (2013). Performance Standards for Antimicrobial Susceptibility Testing, Clinical and Laboratory Standards Institute. Twenty-Third Informational Supplement; CSSI document M100-S23."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"4296","DOI":"10.1128\/JCM.39.12.4296-4301.2001","article-title":"Rapid and accurate species-level identification of coagulase-negative staphylococci by using the sodA gene as a target","volume":"39","author":"Poyart","year":"2001","journal-title":"J. Clin. Microbiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/S0022-2836(05)80360-2","article-title":"Basic local alignment search tool","volume":"215","author":"Altschul","year":"1990","journal-title":"J. Mol. Biol."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/10\/6\/721\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:16:41Z","timestamp":1760163401000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/10\/6\/721"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,16]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["antibiotics10060721"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics10060721","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,16]]}}}