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N. Seki, K. Tokuda, Y. Kamei, M. Matsubara; Coagulase-negative Staphylococci in the Conjunctival Sac and its Antibiotic Susceptibility in Elderly Persons and Staff Members at a Day Service Center in Japan . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1460.
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Purpose: The Long-term Care Insurance (LTCI) System, which started in 2000 in Japan, is a system for supporting the insured and their families by providing them with long-term care service at home or at a day service center. Through this system, those 65 years of age or over who gather together at day service centers may have varying bacterial flora in their conjunctival sacs. They are immuno-compromised hosts and have more opportunities for undergoing intraocular surgery compared to younger people, therefore, it is important to evaluate the bacterial flora in the conjunctival sacs and its antibiotic susceptibility in elderly persons. In this study, we surveyed external ocular cultures in people receiving care at service centers as well as in the staff members helping them. Methods: 92 eyes of 46 people aged 65 years or over with no ocular infections receiving care at a day service center in Tokyo and 16 staff members working at the same center were examined in this study. With informed consent, cultures were obtained by passing a culturette swab over the conjunctival fornix in day-service users and staff members caring for the users. Each finger and nostril of every staff member was also examined. Results: The bacteria were isolated in 68 (73.9%) eyes of elderly people. 41 (51.9%) of 79 bacterial strains were coagulase-negative staphylococci (CNS). Methicillin-resistant CNS (MRCNS) was noted in 1843.9strains of CNS. The resistant rates in MRCNS to NorfloxacinNFLX, OfloxacinOFLXand LevofloxacinLVFXwere 66.7, 66.7 and 44.4, respectively. No MRCNS was retrieved from the fingers of the staff members. Conclusions: The incidence of drug-resistant bacteria from the conjunctival sacs in elderly people receiving the care service showed an increasing tendency compared to previous reports in Japan. The staff members helping the elders at the day service center was identified as not being the source of infection.
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