June 2013
Volume 54, Issue 15
ARVO Annual Meeting Abstract  |   June 2013
Assessment of Risk Factors for Oxacillin-Resistant Ocular Flora from Patients Undergoing Cataract Surgery
Author Affiliations & Notes
  • Hugo Hsu
    Ophthalmology, Doheny Eye Institute, Los Angeles, CA
  • John Lind
    Ophthalmology, Saint Louis University, Saint Louis, MO
  • Darlene Miller
    Ophthalmology, Bascom Palmer Eye Institute, Miami, FL
  • Footnotes
    Commercial Relationships Hugo Hsu, Bausch & Lomb (R); John Lind, Allergan (C), Allergan (R); Darlene Miller, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2907. doi:
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      Hugo Hsu, John Lind, Darlene Miller; Assessment of Risk Factors for Oxacillin-Resistant Ocular Flora from Patients Undergoing Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2907.

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      © ARVO (1962-2015); The Authors (2016-present)

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To assess the risk factors for harboring oxacillin-resistant Staphylococcus species on the ocular surface in a cohort of patients undergoing cataract surgery.


Conjunctival cultures were obtained from patients undergoing cataract surgery on the day of surgery before the instillation of any ophthalmic medications. Patients also answered a questionnaire about risk factors that might lead to having oxacillin-resistant Staphylococcus organisms. The demographic and questionnaire risk factors tested against having oxacillin-resistant organisms were: 1) age, 2) gender, 3) race, 4) recent antibiotic usage, 5) recent hospitalization, and 6) exposure to health-care or institutional settings. Multivariate logistic regression analysis was performed.


183 eyes were cultured. 27 eyes showed no growth. 128 eyes revealed Staphylococcus organisms of which 70 eyes (54.7%) had oxacillin-resistant organisms. Of these 128 subjects, 19 had incomplete questionnaires; therefore a total of 109 subjects were utilized for risk-factor analysis. Of the six risk factors, only prior antibiotic usage was significantly associated with having oxacillin-resistant organisms (OR 8.2; 95% CI 2.2—30.5; p = 0.002). The rest of the risk factors were not significantly associated: age (p = 0.06), gender (p = 0.33), race (p = 0.34), hospitalization (p = 0.94), and institutional settings (p = 0.10).


While the non-ophthalmic literature has put forth various risk factors for patients to harbor oxacillin-resistant organisms, in our cohort of patients undergoing cataract surgery, only antibiotic usage in the preceding 30 days prior to surgery was significantly associated with having oxacillin-resistant organisms on the ocular surface. This finding is of importance to ophthalmic surgeons when considering peri-operative antibiotic prophylaxis.

Keywords: 433 bacterial disease • 464 clinical (human) or epidemiologic studies: risk factor assessment • 720 Staphylococcus  

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