colistin and Endophthalmitis

To report the clinical settings, management and factors affecting outcomes in multi-drug resistant (MDR) and extensively-drug resistant (XDR). Retrospective, consecutive, non-comparative interventional case series. Cases of MDR and XDR. This study included 29 eyes of 29 patients with MDR/XDR. Corneal involvement at presentation is associated with poorer outcomes in MDR and XDR

Topics: Aged; Anti-Bacterial Agents; Colistin; Endophthalmitis; Eye Infections, Bacterial; Humans; Middle Aged; Pseudomonas; Retrospective Studies; Vitrectomy

To determine the possible adverse effects and safe dose range of intravitreal colistin, an antibiotic, after its intravitreal application.. Twenty eyes of 20 adult male and female New Zealand white rabbits were selected. Various concentrations of colistin were prepared. In each rabbit, 0.1 mL of colistin solution or saline solution was injected intravitreally into the right eye. Electroretinographic recordings were taken before and 2 weeks after injection. Histopathological examination was made using a light microscope following enucleation and fixation procedures. In histopathologic cross-sections, the differences between drug-injected eyes and control eyes were evaluated.. Electroretinographic examination showed a decrease of 30% as a significant value in the a and b wave amplitudes of the rabbits that injected 400 µg/0.1 ml and higher concentrations. Histological examination revealed histiocytic infiltration, histiocytic vacuoles, inflammation, and retinal degeneration in rabbit eyes given 400 µg/0.1 ml, 800 µg/0.1 ml, and 1.6 mg/0.1 ml concentrations of colistin.. Based on our findings, the safe concentration of colistin is 0.2 mg/0.1 ml. Administration of 0.4 mg/0.1 ml was associated with cataract development, electrophysiological depression, and pathological changes in retinal layers.

Topics: Animals; Anti-Bacterial Agents; Cataract; Colistin; Disease Models, Animal; Electroretinography; Endophthalmitis; Female; Humans; Intravitreal Injections; Male; Rabbits; Retina; Toxicity Tests, Acute

We report a case of a 35-year-old male with a pancreatic pseudocyst, who developed bilateral endogenous endophthalmitis, 4 days after surgical drainage of the pseudocyst. Bacterial cultures of the pancreatic drain fluid and the vitreous tap showed the growth of Klebsiella pneumoniae. The cultured organism was resistant to all the tested antibiotics except colistin. Intravenous colistin was instituted and three injections of intravitreal colistin were given in the left eye of the patient. Complete resolution of infection was seen and visual acuity of 6/6 was regained in both eyes, which was maintained at 4-month follow-up.

Topics: Adult; Anti-Bacterial Agents; Colistin; Drug Resistance, Multiple, Bacterial; Endophthalmitis; Eye Infections, Bacterial; Follow-Up Studies; Humans; Injections, Intravenous; Intravitreal Injections; Klebsiella Infections; Klebsiella pneumoniae; Male; Pancreatic Pseudocyst; Visual Acuity; Vitreous Body

We report a case series of post-operative endophthalmitis due to Pseudomonas aeruginosa. A total of 8 patients operated for cataract, were referred to our facility with acute onset of decreased vision 1-2 days following surgery. All patients had clinical evidence of acute exogenous endophthalmitis with severe anterior chamber exudative reaction. Ocular samples (aqueous aspirate and vitreous tap) for microbiology were taken from all eyes. Microbiology from all revealed P. aeruginosa which was resistant to all antibiotics except colistin. With prompt and accurate microbiological support it was possible to control the infection in all the eyes with the use of colistin intravitreally and intravenously which to the best of our knowledge, has been never reported. Intravitreal injection of colistin could be an option effective in the management of multi-drug-resistant endophthalmitis caused by Gram-negative bacteria.

Topics: Anti-Bacterial Agents; Colistin; Endophthalmitis; Eye Infections, Bacterial; Female; Follow-Up Studies; Humans; Intravitreal Injections; Male; Middle Aged; Phacoemulsification; Pseudomonas aeruginosa; Pseudomonas Infections; Surgical Wound Infection

Topics: Anti-Bacterial Agents; Colistin; Drug Resistance, Multiple, Bacterial; Endophthalmitis; Humans; Microbial Sensitivity Tests; Pseudomonas aeruginosa; Pseudomonas Infections

A 38-year-old man acquired a Pseudomonas aeruginosa wound infection after transplant nephrectomy. After an initial response to therapy, Pseudomonas sepsis developed, and he was readmitted to the hospital. Two days after admission, blurred vision developed. Ocular examination revealed a severe vitritis and exudate in the pupillary space on the right side. Endogenous endophthalmitis was suspected, and a diagnostic vitreous aspiration yielded P aeruginosa on culture. The patient was treated with intravitreal, subconjunctival, and topical antibiotics as well as periocular steroids, and was able to achieve useful vision before his death from his systemic illness.

Topics: Adult; Colistin; Combined Modality Therapy; Endophthalmitis; Humans; Kidney Transplantation; Male; Pseudomonas Infections; Surgical Wound Infection