Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sisomicin sulphate is a new-generation aminoglycoside with a broad spectrum of antimicrobial activity that includes Pseudomonas aeruginosa. It is superior to gentamicin against indole-negative Proteus and some resistant strains of Pseudomonas. The ocular pharmacokinetics of sisomicin have not been explored. We used the agar diffusion technique of microbial assay to determine the aqueous penetration and bioavailability of a subconjunctivally placed standard dose of 20 mg/0.4 ml of sisomicin sulphate in 20 human volunteers undergoing elective cataract surgery. A peak concentration of 16.4 mg/l was found in the aqueous humour 78 minutes after injection, which is 65 times the minimum inhibitory concentration for Pseudomonas. The antibiotic was bioavailable up to 1203 minutes after injection in a concentration of 0.9 mg/l, which easily covers the minimum inhibitory concentration of Staphylococcus aureus and Pseudomonas. The antibiotic disappears from the aqueous humour at the 1434 minute interval (approximately 24 hours). The elimination half-life (t1/2 of sisomicin was determined to be 5.16 hours (K = 0.134/hour) and the aqueous clearance was 2.87 microliters/min.
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PMID:Aqueous kinetics of sisomicin sulphate. 128 8

The submitted paper deals with an epidemic of severe postoperative panophthalmitis, its development, course, causes and sequelae incl. epidemiological characteristics. The disease developed in four patients 40 hours after operation of cataract. Despite treatment all four patients developed septicaemia and therefore the affected eyeballs were eviscerated. From smears of the conjunctival sac of the affected patients and from the contents of the eviscerated eyeball Proteus mirabilis and Enterobacter cloaceae were cultivated. The authors draw attention to the epidemiological association with the eye lotion BSS which was used from which Proteus mirabilis and E. coli were cultivated and with the Ringer solution from which Enterobacter cloaceae and Klebsiella pneumoniae were cultivated. An epidemiological analysis of the epidemic was made and provisions were defined to rule out its recurrence.
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PMID:[Panophthalmitis as a nosocomial infection]. 136 55

Thirty two cases of endophthalmitis following extracapsular cataract surgery that had occurred within our department and had undergone intraocular diagnostic tap between May 1982 and May 1991 were reviewed. An infectious agent was identified in 20 cases (62.5%). The commonest organism was Staphylococcus epidermidis (11 cases) (55%). Proteus was the only gram negative organism identified (four cases) (20%). Both of these organisms were associated with a favourable visual outcome. In the culture positive subgroup 15 eyes (75%) achieved a final acuity of 6/60 or better with 10 eyes (50%) gaining 6/12 or better. Thirteen (65%) of the culture positive cases were managed without vitreal intervention. Of these 11 (85%) achieved 6/60 or better with eight (62%) gaining 6/12 or better. It appears that when an endophthalmitis follows uncomplicated extracapsular cataract surgery delivery of antibiotic by the 'conventional' routes (topical, subconjunctival and systemic) is consistent with a favourable visual result in many cases. A modified anterior chamber diagnostic tap technique is described.
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PMID:Endophthalmitis following extracapsular cataract surgery: a review of 32 cases. 162 12

Preoperative conjunctival smears of 313 asymptomatic patients before cataract surgery were evaluated in an open multi-center study in 10 German surgical eye care centers from May to August 1987. 230 evaluable isolates of 198 patients (= 61.1%) on agar plates with a 48 h incubation period revealed 190 gram-positive (most frequent isolates: 62.2% coagulase negative Staph., 13.5% coagulase positive Staph.) and 40 gram negative agents (most frequent isolates: 3.0% Proteus sp., 2.2% Pseudomonas sp.). Coinfections with gram-positive organisms were seen in 22%, and with gram-negative organisms in 9% of cases. Newly acquired potentially pathogenic bacteria were demonstrated after one day (5-8 drops 3 mg/ml Tobramycin (Tobramaxin; 1 x ointment in the evening 3 mg/100 mg Tobramycin (Tobramaxin] of topical prophylaxis in 6 of 115 (= 5.2%) previously negative and 22 of 198 (= 11%) previously positive conjunctival cultures. Coagulase negative Tobramycin sensitive Staph. persisted in 41 of 110 patients (= 37.3%) and coagulase positive Tobramycin-sensitive Staph. in 4 of 30 (= 13.3%). Each of the gram-negative bacteria could be eliminated after one day of topical prophylaxis with Tobramycin eye drops and ointment in this study. The statistically determined elimination rate estimated for a one-day topical prophylaxis with Tobramycin in asymptomatic culture-positive persons was 77.5-89.8% (95% confidence interval/Pearson and Clopper). The statistically determined probability for potentially pathogenic bacteria in a previously culture-negative patient after topical preoperative Tobramycin prophylaxis was 3.1-13.2% (95% confidence interval/Pearson and Clopper). Thus, additional supportive antibiotic measures are to be taken pre- and perioperatively by the intraocular surgeon to minimize the risk of postoperative endophthalmitis.
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PMID:[Preoperative microbiologic diagnosis before elective intraocular interventions and prevention of infection with tobramycin eyedrops. Results of a multicenter study]. 204 73

105 patients admitted for cataract surgery were treated pre-operatively with polyvinylpyrrolidone-iodine (PVP-I) as a disinfectant, and consecutive bacterial cultures were obtained before initiating surgery and at the end of the operation. A control group (n = 99) only had a standard disinfection procedure of the eye (including instillation of Terramycin cum polymyxin B cream in the conjunctival sac the evening before surgery). The cultures obtained from the conjunctival sac of the control group principally showed growth of Staph. albus and Staph. aureus, and to a minor degree diphtheroids (Corynebacterium species). Proteus mirabilis, Escherichia coli and micrococci. There was a significant quantitative diminished growth (P less than 0.05) of bacteria in the group of patients treated with PVP-I compared to the control group. Concerning the growth of Staph. albus, this was reduced to almost one third and other bacteria were almost eliminated in the group receiving PVP-I. As we disclosed no toxic or allergic reaction post-operatively which could be related to the use of PVP-I as a disinfectant, this agent seems to constitute an effective pre-operative antimicrobial treatment, taking into consideration the broad antimicrobial spectrum of PVP-I shown by other authors.
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PMID:The effect of polyvinylpyrrolidone-iodine as an disinfectant in eye surgery. 396 22

Two grams of ceftazidime was given to 25 patients before cataract surgery. Mean aqueous humor concentrations of 2.8, 3.2, 3.39, and 1.94 micrograms/mL were observed 30 minutes and 1, 2, 4, and 6 hours, respectively, after administration of the drug. These concentrations are many times higher than the minimum inhibitory concentration (MIC) of ceftazidime against 90% ( MIC90 ) of isolates of Escherichia coli, Klebsiella sp, Proteus mirabilis, and indole-positive Proteus sp. The peak aqueous humor level was also equivalent to or slightly higher than the MIC90 for Pseudomonas aeruginosa.
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PMID:Ceftazidime concentrations in human aqueous humor. 637 45

Monocular patients who wear an ocular prosthesis may harbor pathogenic conjunctival flora both in the socket and in the contralateral eye. They may therefore be at increased risk of developing endophthalmitis after intraocular procedures. We studied a monocular, prosthesis-wearing, 86-year-old man who underwent cataract extraction, subtotal transpupillary vitrectomy, and intraocular lens insertion. Fulminant endophthalmitis ensued postoperatively, and despite complete vitrectomy and administration of intraocular antibiotics, the eye lost light perception. Intravitreal as well as conjunctival cultures bilaterally grew Proteus mirabilis. The patient disclosed that he cleaned the prosthesis frequently because of discharge. We considered an association between this bacterial colonization and the risk of developing postoperative endophthalmitis and suggest prophylactic measures for treatment of monocular patients undergoing intraocular procedures.
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PMID:Postoperative endophthalmitis resulting from prosthesis contamination in a monocular patient. 835 59

We examined ciprofloxacin levels in the aqueous humor, vitreous, or subretinal fluid in 40 patients undergoing cataract extraction, vitrectomy, or scleral buckling. Ciprofloxacin, 750 mg, was administered orally an average of 17 1/2 and 5 1/2 hours preoperatively. We obtained mean ciprofloxacin levels of 0.53 microgram/ml in aqueous humor, 0.51 microgram/ml in vitreous, and 0.71 microgram/ml in subretinal fluid. These vitreous levels exceed the minimum inhibitory concentration (MIC)90 of Staphylococcus epidermidis, Propionibacterium species, Pseudomonas aeruginosa, Proteus mirabilis, and Haemophilus influenzae, as well as the MIC70 of S. aureus and Bacillus cereus. Therefore, ciprofloxacin may have a role in the management and prevention of endophthalmitis.
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PMID:The penetration of oral ciprofloxacin into the aqueous humor, vitreous, and subretinal fluid of humans. 848 15

A diabetic patient who underwent a triple procedure (penetrating keratoplasty, cataract extraction and posterior chamber intraocular lens implantation), developed endophthalmitis caused by Proteus mirabilis. The source of infection was the infected donor cornea, which was imported from Sri Lanka. The organism was resistant to gentamicin, which was the only antibiotic present in the storage medium. On top of an aggressive antibiotic treatment regime (topical, systemic and intravitreal), exchange of the infected with a fresh corneal graft and pars plana vitrectomy were performed. The patient had a speedy recovery and the visual outcome was 20/40 two and a half years after the incident. To our knowledge, post-keratoplasty endophthalmitis caused by P. mirabilis has never been reported in the literature. We report herein such a case with good visual outcome. Newer storage medium, such as Optisol GS, might have a role in preventing keratoplasty-related infection.
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PMID:Post-keratoplasty endophthalmitis caused by Proteus mirabilis. 961 31

The aim of this study was to verify the in vitro influence of various dilutions of a viscoelastic substance containing 2% hydroxy-propyl-methylcellulose (HPMC) on the viability of some microbial strains representative of the normal flora of the external eye. Pure reference strain cultures of Candida albicans, Pseudomonas aeruginosa, Propionibacterium acnes, Staphylococcus aureus, Staphylococcus epidermidis and a fresh clinical isolate of Proteus mirabilis were selected for this study. Serial twofold dilutions of 2% HPMC, prepared so as to obtain a final concentration ranging from 50 to 0.78% of the product in sterile saline solution (0.85% NaCl), were taken out with a pipette that delivered 1.0 ml per tube. One hundred microliters of the abovementioned microbial inocula, used for the evaluation of the positive control of the test organism, were dispensed into each tube. After 24 h of incubation, 100 microl of samples were taken from each tube and plated into the specific medium for the growth of the test organism. After 24-48 h of incubation, these agar plates were examined and the colony-forming-unit count of each test organism was compared to the corresponding total colony count, acting as a positive control, in order to determine the quantitative variation of the test organism grown in the presence of the viscoelastic compounds. C. albicans and P. aeruginosa showed a statistically significant increase in growth with HPMC dilutions varying from 1:2 to 1:16. P. acnes and P. mirabilis growth was significantly reduced by all dilutions except for the 1:128 one. S. epidermidis growth was also significantly reduced in the presence of HPMC dilutions varying from 1:2 to 1:64. S. aureus growth was not significantly influenced. The viability of P. aeruginosa in HPMC dilutions needs to be carefully considered because of the ability of this organism to induce endophthalmitis, and the possibility that during cataract surgery, a small amount of HPMC may be left in the eye, trapped behind the intraocular lens optic.
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PMID:In vitro viability of external eye microbial flora in hydroxy-propyl-methylcellulose. 1042 Jan 12


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