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Cohort studyJournal of ophthalmic inflammation and infection · 2026

Endophthalmitis caused by gram-negative bacteria: etiologies, antibiotic susceptibilities, and treatment outcomes.

Brandon Pham, Charles Zhang, Victor Sanchez … Darlene Miller

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OphthalmologyCohort study

Nearly one-third of gram-negative endophthalmitis patients had no light perception at follow-up.

Endophthalmitis caused by gram-negative bacteria: etiologies, antibiotic susceptibilities, and treatment outcomes.

Brandon Pham … Darlene Miller

Journal of ophthalmic inflammation and infection · 2026

Background

To report the etiologies, antibiotic susceptibilities, and treatment outcomes of patients with culture-proven endophthalmitis associated with gram-negative organisms.

Methods

A single-center retrospective chart review of patients with positive vitreous cultures for gram-negative organisms who presented to a referral center from January 2014 to May 2025.

n = 46 patients

Results

eyes checked at last visit had lost all light perception, worse outcome

VA ≥20/800

13%

No light perception

30.4%

Enucleation/eviscerati

28.3%

More results

The study included 46 patients (mean age 69.5 years; 58.7% male).

The most common isolates were Pseudomonas aeruginosa (19/46, 41.3%), Haemophilus influenzae (8/46, 17.4%), Klebsiella pneumoniae (3/46, 6.5%), Morganella morganii (3/46, 6.5% and Serratia marcescens (3/46, 6.5%).

More results

Lower susceptibility rates were observed for trimethoprim-sulfamethoxazole (12/18, 66.7%) and ceftriaxone (13/15, 86.7%).

All tested organisms were susceptible to meropenem (30/30, 100%).

“

Conclusion · 1 of 2

In the current study, there were generally favorable susceptibilities to commonly used intravitreal antibiotics, but overall patients had poor visual outcomes regardless of specific causative organisms and etiologies.

Conclusion · 2 of 2

Despite appropriate treatment with intravitreal antibiotics and/or pars plana vitrectomy, enucleation and evisceration were common.

Post

Endophthalmitis caused by gram-negative bacteria: etiologies, antibiotic susceptibilities, and treatment outcomes.

Nearly one-third of gram-negative endophthalmitis patients had no light perception at follow-up.

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