Ophthalmic methicillin-resistant Staphylococcus aureus infections: Sensitivity and resistance profiles of 65 isolates in central California

Matthew D. Walvick, Amer Khan

Casa Grande Regional Medical Center, Casa Grande, USA.
John Muir Physician Network, Walnut Creek, USA.

DOI: 10.4236/abb.2013.42A035                

Abstract

Purpose: To capture the sensitivity and resistance trends of ophthalmic Methicillin-resistant Staphylococcus aureus (MRSA) in a heterogenous demographic. Methods: Between 1/1/2004-12/31/2011, ophthalmic MRSA infections were searched in the electronic medical record system ofCommunityRegionalMedicalCenterinFresno,California. We reviewed whether the infection was community-acquired or hospital-acquired, culture site, and sensitivity/resistance profiles. Results: The ophthalmic MRSA isolates tested for vancomycin, sulfamethoxazole-trimethoprim, and gentamycin were 100% sensitive to these to these antibiotics. Tetracycline and rifampin had the next highest sensitivity to resistance ratio, followed by clindamycin. More cases were community-acquired than hospital acquired. Almost half of the hospital-acquired cases were in newborns. Most hospital acquired infections were post-ophthalmic surgery. Conclusion: There is an increasing trend of community- acquired ophthalmic MRSA infection with eyelid involvement being the most common manifestation. Hospital-acquired cases are common in newborns and post-ophthalmic surgery. Have a high index of suspicion for MRSA infection with suspected “insect bites”. Vancomycin, sulfamethoxazole-trimethoprim, gentamycin, tetracycline, and rifampin are good choices to treat ophthalmic MRSA infection. There may be emerging resistance to clindamycin, at least in theCentral Californiaregion. If MRSA infection is suspected, erythromycin and fluoroquinolones should be avoided.

Keywords

Methicillin-Resistant Staphylococcus aureus; MRSA; Eye Infections; Ophthalmic Infections; Ocular Infections

Conflicts of Interest

The authors declare no conflicts of interest.

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