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Matthew M. Kruger, Ji Song, Preston H. Blomquist; Retrospective Review Of Ophthalmic MRSA Infections From 2005-2009 At Parkland Memorial Hospital. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1477.
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To review and characterize five additional years of ophthalmic MRSA cases, investigate changing trends in the incidence of community versus hospital-associated MRSA clones, and examine changing patterns in antibiotic sensitivities.
Case identification through retrospective laboratory and chart review of all positive MRSA cultures obtained at Parkland Memorial Hospital from 2005-2009. Data was collected regarding site of infection, hospital vs. community-associated, risk factors, antibiotic sensitivities and treatment modality.
A total of 7,073 patients with a culture positive for MRSA were identified, of which 5,617 (79%) were considered to be community acquired and 1,456 (21%) were considered to be hospital associated. Of the total, 61 (0.78%) involved the eye or the orbit. In general, the number of hospital and community-associated infections remained stable over the five-year case series for both ophthalmic and non-ophthalmic infections. Patients with ophthalmic involvement were, on average, younger (32.2 vs. 40.0 years old). The most common manifestation of ophthalmic MRSA continued to be preseptal cellulitis and/or lid abscess, followed by conjunctivitis. Sight-threatening infections, such as corneal ulcers, orbital cellulitis and endophthalmitis, continued to occur with similar incidence as compared to the years 2000-2004. Empiric coverage for infection was started in 98% of patients, but the prescribed antibiotic was not active against MRSA in 33% of cases.
Our study indicates that the previously demonstrated rapid growth in the incidence of community-acquired MRSA appears to be slowing, both in ophthalmic infections and non-ophthalmic infections, in a major urban county hospital. The demographics and site of infection also appear stable. There has been little change in the antibiotic sensitivity pattern of MRSA over a ten year period. Despite this stabilizing trend in infections, MRSA remains a common and formidable pathogen.
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