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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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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.
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