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Edward W. Trudo, Jr.; Incidence of MRSA/MRSE and Co-existing Ophthalmic Drug Resistance in Refractive Surgery Seeking Patients. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4046.
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To report the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE) colonization in refractive surgery seeking patients and to evaluate co-existing resistance to normally prescribed ophthalmic medications.
A retrospective review was conducted on 36 refractive surgery patient records in a high-risk group who underwent nasal and ocular cultures as part of a performance improvement process to identify MRSA/MRSE carrier status before refractive surgery. All 36 patients were included for analysis. Patient cultures that were positive for MRSA/MRSE were further analyzed for co-existing resistance to ciprofloxacin, levofloxacin, moxifloxacin, and polymyxin B sulfate/trimethoprim.
Positive cultures for MRSA/MRSE were found in 6 patients (16.6 %). The nares were the most common site, found in all 6 patients. Only 1 ocular culture was positive (2.7%) and coexisted in a positive nasal culture patient. MRSA was found in 4 patients (11.1%) and MRSE was positive in 2 patients (5.5%). Co-existing ophthalmic drug resistance is presented in Table 1.
Methicillin-resistant Staphylococcus cultures were positive in 6 individuals of this 36 patient high-risk group who presented for refractive surgery evaluation and were otherwise asymptomatic. Ocular cultures alone will not identify MRSA and MRSE carriers. MRSA and MRSE may also exhibit resistance to any of the medications normally prescribed after refractive surgery.
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