Methicillin-Resistant Staphylococcus aureus and Methicillin-Resistant Staphylococcus epidermidis Infections in the Cornea

Sotozono, Chie; Inagaki, Kayoko; Fujita, Atsuko; Koizumi, Noriko; Sano, Yoichiro; Inatomi, Tsutomu; Kinoshita, Shigeru

doi:10.1097/01.ico.0000263127.84015.3f

Cited by 108 publications

(86 citation statements)

References 5 publications

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“…Vancomycin has been used frequently with success, although in rare instances in-house preparations of higher strength 5% vancomycin were required. 6 Underlying medical problems are a common finding in several studies including ours where respiratory, malignant, and cerebrovascular disease was prominent. Fukuda et al 7 reported MRSA conjunctival commensals to be three times higher in chronically bedridden patients and 1.5 times greater in patients with anaemia, malignancy, and liver dysfunction when compared with normals.…”

Section: Discussionmentioning

confidence: 78%

“…Recently, two centres from Japan have published more comprehensive work in this field looking at several aspects of MRSA ocular infections. 6,7 Interesting comparisons of the cases in our study and that of previous work can be made.…”

Section: Discussionmentioning

confidence: 78%

“…These findings are similar to the majority of cases observed in a large series of MRSA and methicillin-resistant Staphylococcal epidermidis ocular surface infections. 6 The authors proposed a four level grading system for the methicillinresistant keratitis, one being the mildest referring only to carriers and four for destructive keratitis leading to perforation. Three of the cases of isolated conjunctivitis in our series were noted to have a purulent discharge.…”

Section: Discussionmentioning

confidence: 99%

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External ocular infections due to methicillin-resistant Staphylococcus aureus (MRSA)

Shanmuganathan

Armstrong

Buller

et al. 2004

Eye

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Purpose To determine the prevalence and clinical characteristics of external ocular infections caused by methicillin-resistant Staphylococcus aureus (MRSA) in an ophthalmic hospital in the UK. Methods A retrospective analysis of the case notes of patients who had culture proven external ocular Staphylococcal infections during a 44-month period was undertaken. Results There were a total of 548 external eye infections caused by Staphylococcus aureus. Of these, 17 (3%) were MRSA positive. The most common presentation was conjunctivitis seen in six patients. All MRSA isolates were sensitive to chloramphenicol. Ofloxacin resistance was observed in all isolates from patients over the age of 50 years. All patients had an underlying history of either an ocular surface disease, malignancy, or a debilitating medical illness. Conclusions MRSA is as yet an infrequent cause of external ocular infections. Patients typically have underlying ocular risk factors and/or are medically debilitated. Different strains infect young and old age groups with characteristic antimicrobial sensitivity. This study highlights the need for more work to establish the role of MRSA commensals and ocular infections.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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External ocular infections due to methicillin-resistant Staphylococcus aureus (MRSA)

Shanmuganathan

Armstrong

Buller

et al. 2004

Eye

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“…Reports of MRSA ophthalmic infections are numerous in the literature. They are more commonly seen in patients in neonatal ICUs [61][62][63], in post-ocular surgical patients [64][65][66][67][68][69][70][71][72][73][74][75], among healthcare workers [76,77] after corneal refractive surgery [77][78][79][80][81][82][83][84], in hospitalized pediatric patients [85], and in patients with chronic medical disease, immuno-suppression, or immunodeficiency [70,86].…”

Section: Target Populations and Transmissionmentioning

confidence: 99%

Methicillin-Resistant Staphylococcus aureus and the Eye: Current Concepts and Management Strategies

Ritterband

2013

Curr Ophthalmol Rep

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Methicillin-resistant Staphylococcus aureus (MRSA) remains one of the most important causes of nosocomial infections worldwide. This review explores the history and epidemiology of MRSA infections with a detailed analysis of its molecular subtyping, target populations, virulence factors, and modes of transmission. In addition, it specifically discusses the spectrum of eye diseases caused by MRSA, reviews the current ophthalmic literature, addresses the controversy regarding ophthalmic antibiotic resistance to MRSA, and examines alternative treatment strategies.

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“…In cases where the treatment induced the regression of cell infiltrations, or the corneal ulcer was localized and did not progress, instillations of 3.1% vancomycin and 2% amikacin were gradually reduced to prevent drug toxicity that may influence corneal epithelialization and vascularization. When keratitis was unresponsive to these therapies, antimicrobial therapy was changed by adding 5% vancomycin ointment 8 or 0.5% moxifloxacin eye drops 4-6 times/day or as per culture and sensitivity reports, if available.…”

Section: Treatmentmentioning

confidence: 99%

Outbreak of Gram-positive bacterial keratitis associated with epidemic keratoconjunctivitis in neonates and infants

Kim

et al. 2008

Eye

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Objectives To report the clinical characteristics of bacterial keratitis associated with epidemic keratoconjunctivitis (EKC) and to evaluate the risk factors for bacterial keratitis development in eyes with EKC. Methods After 108 patients diagnosed as EKC were retrospectively reviewed, clinical characteristics and incidence of bacterial keratitis-associated EKC were described. To analyse the effect of steroid use and the methicillin-resistant Staphylococcus aureus (MRSA) colonization in conjunctiva on developing bacterial keratitis, HCU-stayed children (n ¼ 43) were divided into two groups: those with and those without bacterial keratitis. Other risk factors such as gestational age, duration of hospitalization, MRSA colonization rate of other sites, and interval between follow-ups were evaluated in neonates who stayed in a neonatal intensive care unit (NICU; n ¼ 29). Results Eight out of nine bacterial keratitis developed in HCU-stayed children. All the eight cases of bacterial keratitis occurred in neonates and infants. MRSA keratitis was found in seven hospitalized infants. The incidence of bacterial keratitis was significantly higher in HCU-stayed children than in outpatients (P ¼ 0.03), although it never occurred in HCU-stayed adults. The culture-positive rate of MRSA in conjunctiva (P ¼ 0.047) and topical use of steroid (P ¼ 0.01) were significantly higher in HCU-stayed children who carried bacterial keratitis. The incidence of bacterial keratitis was significantly related with the longer interval of follow-up in early EKC period in NICU in patients (P ¼ 0.009). Conclusions Infants and neonates show high tendency of MRSA keratitis accompanied with EKC, especially if they were in HCU, applied topical steroid or followed with long interval.

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Methicillin-Resistant Staphylococcus aureus and Methicillin-Resistant Staphylococcus epidermidis Infections in the Cornea

Cited by 108 publications

References 5 publications

External ocular infections due to methicillin-resistant Staphylococcus aureus (MRSA)

External ocular infections due to methicillin-resistant Staphylococcus aureus (MRSA)

Methicillin-Resistant Staphylococcus aureus and the Eye: Current Concepts and Management Strategies

Outbreak of Gram-positive bacterial keratitis associated with epidemic keratoconjunctivitis in neonates and infants

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