Treatment of two postoperative endophthalmitis cases due to Aspergillus flavus and Scopulariopsis spp. with local and systemic antifungal therapy

<p>Abstract</p> <p>Background</p> <p>Endophthalmitis is the inflammatory response to invasion of the eye with bacteria or fungi. The incidence of endophthalmitis after cataract surgery varies between 0.072–0.13 percent. Treatment of endophthalmitis with fungal etiology is difficult.</p> <p>Case Presentation</p> <p><b>Case 1: </b>A 71-year old male diabetic patient developed postoperative endophthalmitis due to <it>Aspergillus flavus</it>. The patient was treated with topical amphotericin B ophthalmic solution, intravenous (IV) liposomal amphotericin-B and caspofungin following vitrectomy.</p> <p><b>Case 2: </b>A 72-year old male cachectic patient developed postoperative endophthalmitis due to <it>Scopulariopsis </it>spp. The patient was treated with topical and IV voriconazole and caspofungin.</p> <p>Conclusion</p> <p><it>Aspergillus </it>spp. are responsible of postoperative fungal endophthalmitis. Endophthalmitis caused by <it>Scopulariopsis </it>spp. is a very rare condition. The two cases were successfully treated with local and systemic antifungal therapy.</p

Is isepamicin a solution for aminoglycoside resistance?

Aminoglycosides are commonly used antibiotics especially in hospital-acquired infections. As a result of their widespread usage, resistance to these antibiotics is increasing. Isepamicin is a newly developed aminoglycoside and it is claimed that resistance to this antibiotic will develop in lower frequency in comparison with other aminoglycosides. This study was conducted to evaluate the resistance patterns of Gram-negative isolates to aminolycosides and to compare isepamicin with other aminoglycosides. All Gram-negative bacteriae isolated from blood and other cultures during the years 2000-2001 were tested against gentamicin, tobramycin, netilmicin, amikacin and isepamicin. The in-vitro susceptibility tests were performed by disk diffusion method. In total 3683 Gram-negative isolates were studied. According to our results, netilmicin (66.4%) was the most effective aminoglycoside. It was followed by isepamicin (64%), amikacin (63%), tobramicin (55.9%) and gentamicin (51.9%). Netilmicin was also the most effective aminoglycoside against Gram-negative bacteriae isolated from blood culture. Amikacin (62.6%) and isepamicin (62.5%) were equally effective against these isolates. In conclusion, netilmicin was the most effective aminoglycoside against Gram negative bacteriae. The resistance to isepamicin was significant

Pathogens isolated from deep soft tissue and bone in patients with diabetic foot infections

Background: We sought to determine the similarity of pathogens isolated from soft tissue and bone in patients with diabetic foot infections. It is widely believed that soft-tissue cultures are adequate in the determination of causative bacteria in patients with diabetic foot osteomyelitis. The culture results of specimens taken concurrently from soft-tissue and bone infections show that the former does not predict the latter with sufficient reliability. We sought to determine the similarity of pathogens isolated from soft tissue and bone in patients with diabetic foot infections