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J.C. Major, Jr., H.W. Flynn, Jr., D. Miller, W.E. Smiddy, T.G. Murray; Antibiotic Sensitivities and Visual Acuity Outcomes in Endophthalmitis Caused by Methacillin–Sensitive (MSSA) versus Methacillin–Resistant (MRSA) Staphylococcus aureus . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5282.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the antibiotic sensitivities and visual acuity (VA) outcomes of culture proven methacillin–sensitive (MSSA) versus methacillin–resistant (MRSA) Staphylococcus aureus endophthalmitis.
A retrospective, consecutive, case series of all patients with culture proven Staphylococcus aureus endophthalmitis seen at the Bascom Palmer Eye Institute from January 1, 1995 – July 1, 2005 were reviewed for antibiotic sensitivities, VA at presentation and at subsequent intervals. Polymicrobial cases were not included.
This study examined 28 cases of Staphylococcus aureus endophthalmitis (17 MSSA, 11 MRSA) in 28 patients. The etiologies were cataract surgery 16/28 (57%), endogenous 5/28 (18%), bleb–associated 3/28 (11%) and miscellaneous 4 (14%). All isolates were sensitive to vancomycin. MSSA was greater than 94% sensitive to all tested antibiotics, except penicillin, while increasing resistance was detected in the MRSA isolates. The MRSA group exhibited statistically significant reduced sensitivities to both older generation fluoroquinolones (ocufloxacin 4/11 [36%] and ciprofloxacin 5/11 or [45%]) was well as the newer fourth generation fluoroquinolones (moxifloxacin 5/11 or [45%] and gatifloxacin 5/11 or [45%]). The median presenting VA was hand motion range for both MSSA and MRSA cases. A VA of 20/400 was seen in 57% of MSSA cases and 40% of MRSA cases at three months. Overall, logMAR VA outcomes after treatment for MSSA and MRSA isolates were statistically similar at time intervals of one month (p=.83) and three months (p=.88).
In the current study, MRSA isolates were more likely to exhibit resistance to a wide variety of antibiotics including the fourth generation flouroquinolones. VA outcomes showed no statistically significant differences between MRSA and MSSA groups after 3 months of follow–up.
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