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agglomerans in the Endophthalmitis Vitrectomy Study.8 The purpose of this study is to describe the clinical features, antibiotic susceptibilities, and visual acuity outcomes of three patients with endophthalmitis caused by P. agglomerans in the United States. Very limited data exist on P. agglomerans across all disciplines of medicine; however, the most common reports involve septicemia and septic arthritis following penetrating trauma with plant matter or nosocomial infections.1,9,10 Over the last decade, there have been several septicemia outbreaks in neonatal centers secondary to contaminated parenteral nutrition,11 intravenous fluids,12 and contaminated anticoagulant citrate-dextrose 46% solution.13 Based on a PubMed search, this is the largest series of P. agglomerans endophthalmitis to be reported from the United States. Using published literature for comparison, this is the first study to evaluate antibiotic sensitivities of isolates of P. agglomerans in patients with endophthalmitis from different regions. Methods Institutional review board approval was obtained from the University of Miami Miller School of FRAX597 solubility dmso Medicine Sciences Subcommittee for the Protection of Human Subjects. The Ocular Microbiology Department database was searched to identify all patients with positive vitreous cultures for P. agglomerans (E. agglomerans) between January 1, 1990 and December 31, 2012 at the Bascom Palmer Eye Institute (Miami, FL, USA). Records from the microbiology department were reviewed to identify microbial isolates and antibiotic sensitivities. Vitreous cultures were obtained during vitrectomy or at the time of vitreous tap. Fluid from a vitreous tap was placed directly onto culture media including 5% sheep blood and chocolate agars. For vitrectomy specimens, 30�C50 mL of vitreous washings were filtered using a 0.45 ��m filter. The resultant filter paper was divided into sections and plated onto different culture media, which typically included chocolate and blood agars. Blood and chocolate agars underwent incubation at 35��C for up to 2 weeks. Additional culture media, including thioglycollate broth, were performed at the discretion of the ophthalmologist performing the culture. All cultures were read and classified by the Ocular Microbiology Department staff using the VITEK automated microbial system (Biomerieux Vitek, Hazelwood, MO, USA). The medical records of each patient listed in our database with a positive P. agglomerans culture were reviewed to ensure they had a clinical course consistent with endophthalmitis. Patient demographics, clinical features, treatment strategies, and clinical outcomes were assessed. The clinical features, treatment strategies, and clinical outcomes from our institution were compared to those from previously published cases. Additionally, a comparison was made between the antibiotic resistance patterns between isolates from the United States and Asia.