Methicillin-Resistant Staphylococcus aureus Infectious Keratitis Following Refractive Surgery

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

“…Published reports of MRSA infections specifically after refractive surgery and cataract surgery at that time raised an ominous specter concerning these infections, especially in light of the fact that many of the cultured organisms had been fluoroquinolone-resistant [75,[77][78][79][80][81][82][83][84]. However, many of the published small reports lack the study power to definitively illustrate the epidemiology of these infections.…”

“…FitzgeraldHughes et al [116] discussed cationic antimicrobial peptides and ''antipathogenic agents'' which interfere with bacterial virulence mechanisms (host binding, biofilm formation, evasion of phagocytosis, and toxin production) as novel therapies to combat MRSA. Cheung et al [120 • [71] Ocular surface reconstruction Hori et al [64] Cornea cross-linking Bödemann and Kohnen [66] Post refractive surgery Solomon et al [77] Woodward and Randelman [78] Nomi et al [80] Magli et a.l [79] Karth and Karth [83] an immunization therapy that potentially uses multiple antibodies directed against a series of genome-encoded toxins of MRSA. Suzuki discussed antibiotics such as targocil targeting wall teichoic acids (WTA).…”

“…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].…”

“…Perhaps the most common are those reported after eye surgery and/or concerning post-operative endophthalmitis. Recent reports in the last decade on endophthalmitis or postoperative infection include small retrospective cases series or case reports following cataract surgery [65,70,83,98], after amniotic membrane transplantation [64], following scleral buckle placement [68], following PK [69], following Ahmed valve placement [71], and after cornea refractive surgery [77][78][79][80][81][82][83][84]. Other reports are frequently site-specific, including orbital cellulitis [99][100][101][102][103][104], lacrimal system involvement [91,[105][106][107], and, most recently, after brow epilation [108].…”

Postantibiotic Effects and Bactericidal Activities of Levofloxacin and Gatifloxacin at Concentrations Simulating Those of Topical Ophthalmic Administration against Fluoroquinolone-Resistant and Fluoroquinolone-Sensitive Methicillin-Resistant Staphylococcus aureus Strains

“…Ocular infections caused by methicillin-resistant Staphylococcus aureus (MRSA) strains, which are clinically serious and difficult to treat, have been reported (18,(27)(28)(29)(30)34). The prevalence of levofloxacin (LVX) resistance in MRSA strains isolated from patients with ocular infections is 80 to 90% in Japan and the United States (12,14,17).…”