Comparative Study of Staphylococcus epidermidis Virulence Profiles in an animal Model of Endophthalmitis

Introduction: Gram-positive staphylococci are responsible for over 90% of cases of postoperative infectious endophthalmitis, with Staphylococcus epidermidis accounting for approximately 70% of isolated microorganisms. Objective: To evaluate the relationship between S. epidermidis virulence and severity of endophthalmitis in an animal model. Methodology: New Zealand albino rabbits were divided into two groups and administered 100 colony-forming units of S. epidermidis strains. In the virulent group, four rabbits received a multi-antibiotic resistant, mecA, ica, and atlE gene carrying S. epidermidis strain, from a patient´s conjuntival microbiota and three a biofilm-forming S. epidermidis ATCC 35984. In the non-virulent group, five rabbits were inoculated with a strain sensitive to all tested antibiotics and lacking mecA, ica, and atlE genes, also from a patient and three rabbits received the non-producer biofilm S. epidermidis ATCC 29122. Clinical and ultrasound examinations were conducted every three hours until endophthalmitis symptoms appeared, followed by daily clinical assessments. Histological evaluations were performed 15 days post-inoculation. Results: The less virulent group displayed milder inflammation and reduced intraocular damage in comparison to the more virulent group based on clinical and ultrasound observations. Nevertheless, histopathological analysis revealed similar inflammation in all groups, 15 days post-inoculation. Discussion: Less virulent S. epidermidis strains induced less severe inflammation as observed through clinical and ultrasound assessments. However, long-term histopathological assessments showed effects comparable to those seen with the more virulent strain

CORRESPONDENCE Prospective

comparative evaluation of povidone–iodine (10 % for 5 minutes versus 5 % for 1 minute) as prophylaxis for ophthalmic surger

Clinical results of topical fluconazole for the treatment of filamentous fungal keratitis

Background: Fungal keratitis is a rare but serious condition that may result in loss of vision. the potentially poor prognosis might be due to a delay in diagnosis and/or to limited treatment options. the aim of this study is to evaluate the clinical outcome of patients treated with topical fluconazole 0.2% for the treatment of filamentous fungal keratitis. Methods: Retrospective case series. A chart review of all patients evaluated at the Ophthalmology Department of the Hospital de Clnicas in Paraguay from January 1997 to December 2000 identified 25 cases of fungal keratitis. Among these cases, one patient discontinued the treatment and another received amphotericin as the first line drug, resulting in 23 cases available for data analysis. Twelve patients were treated with topical fluconazole 0.2% alone (Group I) and 11 patients received a combination of topical fluconazole 0.2% and oral ketoconazole 200 mg twice daily (Group II). Results: Sixteen of 23 cases showed resolution of the keratitis, 9/12 (75%) in Group I and 7/11 (64%) in Group II. Seven patients (30%) did not respond to medical treatment and required a surgical procedure to preserve eye integrity. Superficial and small ulcers have a significantly better prognosis than do lrge and deep ulcers. Concomitant oral ketoconazole (400 mg/day) did not improve the clinical results. Conclusions: Our findings of study suggest that topical fluconazole 0.2% is a safe and effective antifungal drug for the management of filamentous mycotic keratitis, particularly in cases that are not severe. the addition of oral ketoconazole to topical fluconazole did not improve the clinical outcome.Univ Nacl Asunc, Hosp Clin, Dept Ophthalmol, Asuncion, ParaguayStanford Univ, Sch Med, Dept Ophthalmol, Stanford, CA 94305 USAUniversidade Federal de São Paulo, Escola Paulista Med, Dept Ophthalmol, São Paulo, BrazilUniv Munich, Dept Ophthalmol, Munich, GermanyUniversidade Federal de São Paulo, Escola Paulista Med, Dept Ophthalmol, São Paulo, BrazilWeb of Scienc