TITLE:
Ophthalmic methicillin-resistant Staphylococcus aureus infections: Sensitivity and resistance profiles of 65 isolates in central California
AUTHORS:
Matthew D. Walvick, Amer Khan
KEYWORDS:
Methicillin-Resistant Staphylococcus aureus; MRSA; Eye Infections; Ophthalmic Infections; Ocular Infections
JOURNAL NAME:
Advances in Bioscience and Biotechnology,
Vol.4 No.2A,
February
28,
2013
ABSTRACT:
Purpose: To capture the sensitivity and resistance
trends of ophthalmic Methicillin-resistant Staphylococcus aureus (MRSA) in a heterogenous demographic. Methods: Between 1/1/2004-12/31/2011,
ophthalmic MRSA infections were searched in the electronic medical record
system ofCommunityRegionalMedicalCenterinFresno,California.
We reviewed whether the infection was community-acquired or hospital-acquired,
culture site, and sensitivity/resistance
profiles. Results: The ophthalmic MRSA isolates tested for vancomycin,
sulfamethoxazole-trimethoprim, and gentamycin were 100% sensitive to these to
these antibiotics. Tetracycline and rifampin had the next highest sensitivity
to resistance ratio, followed by clindamycin. More cases were community-acquired
than hospital acquired. Almost half of the hospital-acquired cases were in
newborns. Most hospital acquired infections were post-ophthalmic surgery. Conclusion: There is an increasing trend of community- acquired ophthalmic MRSA
infection with eyelid involvement being the most common manifestation. Hospital-acquired
cases are common in newborns and post-ophthalmic surgery. Have a high index of
suspicion for MRSA infection with suspected “insect bites”. Vancomycin, sulfamethoxazole-trimethoprim, gentamycin,
tetracycline, and rifampin are good choices to treat ophthalmic MRSA
infection. There may be emerging resistance to clindamycin, at least in theCentral Californiaregion. If MRSA infection is suspected, erythromycin and fluoroquinolones should be avoided.