{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T14:28:21Z","timestamp":1784989701244,"version":"3.55.0"},"reference-count":29,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"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>Background: Examining the effect of antibiotic resistance, use of intravitreal antibiotics and systemic corticosteroids on visual outcome of eyes with acute endophthalmitis. Methods: We included 226 eyes with acute endophthalmitis, treated using a standardized protocol. Visual outcome up to 12 months was assessed related to biopsy results, antibiotics resistance and treatment regimens. Results: Vitreous biopsies were more likely to be culture-positive (41.1%) than anterior chamber biopsies (21.6%, p &lt; 0.0001). Antibiotic resistance for amikacin was found in 19 eyes (24.7%), vancomycin in 29 eyes (31.5%) and moxiflocacin in 14 eyes (16.1%). At presentation 91.53% of eyes had BCVA &lt; 20\/40, reducing by 1 month to 69.94% (p &lt; 0.0001) and remaining stable at 12 months. There was no difference in visual outcome for those receiving early systemic corticosteroids. Endophthalmitis following cataract surgery (OR 1.66, 1.04\u20132.66 95% CI, p = 0.03) and receiving intravitreal vancomycin (OR 3.15, 1.18\u20138.42 95% CI, p = 0.02) were associated with a greater chance of final BCVA \u2265 20\/40. Conclusion: Using vitreous taps with intravitreal antibiotics, despite an increase in resistance to both vancomycin and moxifloxacin, results in a final BCVA &gt; 20\/200 in half of eyes and \u226520\/40 in a third. Early treatment with intravitreal antibiotics should not be delayed.<\/jats:p>","DOI":"10.3390\/antibiotics11070843","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T21:25:00Z","timestamp":1656019500000},"page":"843","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Emerging Antibiotic Resistance Patterns Affect Visual Outcome Treating Acute Endophthalmitis"],"prefix":"10.3390","volume":"11","author":[{"given":"Xia-Ni","family":"Wu","sequence":"first","affiliation":[{"name":"NIHR Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK"},{"name":"Institute of Ophthalmology, University College London, London EC1V 9EL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2682-939X","authenticated-orcid":false,"given":"Yi-Hsing","family":"Chen","sequence":"additional","affiliation":[{"name":"NIHR Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK"},{"name":"Institute of Ophthalmology, University College London, London EC1V 9EL, UK"},{"name":"Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan 10507, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lazha","family":"Sharief","sequence":"additional","affiliation":[{"name":"NIHR Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK"},{"name":"Institute of Ophthalmology, University College London, London EC1V 9EL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Al-Janabi","sequence":"additional","affiliation":[{"name":"NIHR Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK"},{"name":"Institute of Ophthalmology, University College London, London EC1V 9EL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nura","family":"Al Qassimi","sequence":"additional","affiliation":[{"name":"NIHR Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Lightman","sequence":"additional","affiliation":[{"name":"NIHR Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK"},{"name":"Institute of Ophthalmology, University College London, London EC1V 9EL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oren","family":"Tomkins-Netzer","sequence":"additional","affiliation":[{"name":"NIHR Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK"},{"name":"Institute of Ophthalmology, University College London, London EC1V 9EL, UK"},{"name":"Department of Ophthalmology, Lady Davis Carmel Medical Center, Ruth and Bruch Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3200003, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"(1995). Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Endophthalmitis Vitrectomy Study Group. Arch. Ophthalmol., 113, 1479\u20131496.","DOI":"10.1001\/archopht.1995.01100120009001"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/S0039-6257(98)00036-8","article-title":"Endophthalmitis","volume":"43","author":"Kresloff","year":"1998","journal-title":"Surv. Ophthalmol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.ophtha.2019.08.026","article-title":"Endophthalmitis after Cataract Surgery in the United States: A Report from the Intelligent Research in Sight Registry, 2013\u20132017","volume":"127","author":"Pershing","year":"2020","journal-title":"Ophthalmology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.survophthal.2018.02.003","article-title":"Management of bacterial postoperative endophthalmitis and the role of vitrectomy","volume":"63","author":"Clarke","year":"2018","journal-title":"Surv. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1111\/ceo.13768","article-title":"Gram-negative endophthalmitis: A prospective study examining the microbiology, clinical associations and visual outcomes following infection","volume":"48","author":"Stevenson","year":"2020","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.jgar.2022.03.010","article-title":"Antibiotic susceptibility of bacterial pathogens isolated from the aqueous and vitreous humour in the Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) Surveillance Study: 2009\u20132020 update","volume":"23","author":"Asbell","year":"2022","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/ICU.0000000000000727","article-title":"Endophthalmitis after cataract surgery: An update on recent advances","volume":"32","author":"Peck","year":"2021","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1136\/bjophthalmol-2015-307722","article-title":"Endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility: Literature review and options for treatment","volume":"100","author":"Relhan","year":"2016","journal-title":"Br. J. Ophthalmol."},{"key":"ref_9","first-page":"127","article-title":"Endophthalmitis following cataract surgery and intracameral antibiotic: Moxifloxacin resistant Staphylococcus epidermidis","volume":"8","author":"Chang","year":"2018","journal-title":"Am. J. Ophthalmol. Case Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s40942-021-00280-1","article-title":"Surveillance of post-cataract endophthalmitis at a tertiary referral center: A 10-year critical evaluation","volume":"16","author":"Kato","year":"2021","journal-title":"Int. J. Retin. Vitr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e572","DOI":"10.1111\/j.1755-3768.2011.02365.x","article-title":"Adjunctive antibiotics in the treatment of acute bacterial endophthalmitis following cataract surgery","volume":"90","author":"Hooper","year":"2012","journal-title":"Acta Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/j.ophtha.2005.01.050","article-title":"Management and outcomes of postoperative endophthalmitis since the endophthalmitis vitrectomy study: The Endophthalmitis Population Study of Western Australia (EPSWA)\u2019s fifth report","volume":"112","author":"Ng","year":"2005","journal-title":"Ophthalmology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1016\/j.oret.2020.04.026","article-title":"Clinical Decision Making and Visual Outcomes in Endophthalmitis Treated with Systemic Corticosteroids","volume":"4","author":"Robbins","year":"2020","journal-title":"Ophthalmol. Retin."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/S0039-6257(97)00005-2","article-title":"Antibiotic selection in the treatment of endophthalmitis: The significance of drug combinations and synergy","volume":"41","author":"Roth","year":"1997","journal-title":"Surv. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/1869-5760-3-46","article-title":"Vancomycin-resistant Gram-positive bacterial endophthalmitis: Epidemiology, treatment options, and outcomes","volume":"3","author":"Khera","year":"2013","journal-title":"J. Ophthalmic Inflamm. Infect."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ajoc.2018.02.030","article-title":"Endophthalmitis caused by gram-positive bacteria resistant to vancomycin: Clinical settings, causative organisms, antimicrobial susceptibilities, and treatment outcomes","volume":"10","author":"Shivaramaiah","year":"2018","journal-title":"Am. J. Ophthalmol. Case Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1136\/bjo.2006.112060","article-title":"Pharmacokinetics of vancomycin following intracameral bolus injection in patients undergoing phacoemulsification cataract surgery","volume":"91","author":"Murphy","year":"2007","journal-title":"Br. J. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/IAE.0b013e31814fb0ed","article-title":"Vitreal penetration of oral moxifloxacin in humans","volume":"28","author":"Lott","year":"2008","journal-title":"Retina"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1001\/archopht.124.2.178","article-title":"Vitreous and aqueous penetration of orally administered moxifloxacin in humans","volume":"124","author":"Hariprasad","year":"2006","journal-title":"Arch. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.ajo.2006.09.023","article-title":"Vitreal penetration of oral and topical moxifloxacin in humans","volume":"143","author":"Fuller","year":"2007","journal-title":"Am. J. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1001\/jamaophthalmol.2017.1826","article-title":"Trends in Fluoroquinolone Nonsusceptibility Among Coagulase-Negative Staphylococcus Isolates Causing Endophthalmitis, 1995\u20132016","volume":"135","author":"Stringham","year":"2017","journal-title":"JAMA Ophthalmol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"592.e1","DOI":"10.1016\/j.cmi.2015.01.028","article-title":"Correlation between clinical data and antibiotic resistance in coagulase-negative Staphylococcus species isolated from 68 patients with acute post-cataract endophthalmitis","volume":"21","author":"Chiquet","year":"2015","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1016\/j.jcrs.2008.05.043","article-title":"Laboratory diagnosis of endophthalmitis: Comparison of microbiology and molecular methods in the European Society of Cataract & Refractive Surgeons multicenter study and susceptibility testing","volume":"34","author":"Seal","year":"2008","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s12348-020-0200-0","article-title":"In vitro Susceptibilities of Methicillin-Susceptible and Resistant Staphylococci to Traditional Antibiotics Compared to a Novel Fluoroquinolone","volume":"10","author":"Fan","year":"2020","journal-title":"J. Ophthalmic Inflamm. Infect."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1016\/j.oret.2018.04.008","article-title":"Practice Patterns of Endophthalmitis Treatment: An International Survey of Retina Specialists","volume":"2","author":"Xu","year":"2018","journal-title":"Ophthalmol. Retin."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1016\/j.ophtha.2018.01.022","article-title":"Endophthalmitis after Intravitreal Injection of Vascular Endothelial Growth Factor Inhibitors: Management and Visual Outcomes","volume":"125","author":"Xu","year":"2018","journal-title":"Ophthalmology"},{"key":"ref_27","first-page":"196094","article-title":"Role of inflammation in endophthalmitis","volume":"2012","author":"Vinciguerra","year":"2012","journal-title":"Mediat. Inflamm."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s10792-019-01153-1","article-title":"Endophthalmitis after intravitreal injections versus cataract surgery: A 15-year cohort","volume":"40","author":"Dar","year":"2020","journal-title":"Int. Ophthalmol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2387","DOI":"10.1016\/j.ophtha.2014.07.007","article-title":"Long-term clinical outcome and causes of vision loss in patients with uveitis","volume":"121","author":"Talat","year":"2014","journal-title":"Ophthalmology"}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/11\/7\/843\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:38:51Z","timestamp":1760139531000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/11\/7\/843"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,23]]},"references-count":29,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["antibiotics11070843"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics11070843","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,23]]}}}