Spectrum of eye disease caused by methicillin-resistant Staphylococcus aureus.
OBJECTIVE
To compare the clinical features and antibiotic susceptibility of ocular methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA).


METHODS
Cross-sectional study.


METHODS
The Proctor clinical laboratory database was reviewed to identify all ocular isolates of S. aureus collected between July 1, 1998 and July 31, 2006.


RESULTS
Of 915 S. aureus isolates, there were 88 MRSA isolates in 41 different patients. The proportion MRSA increased from 4.1% in 1998 to 1999 to 16.7% in 2005 to 2006. A total of 78.0% of patients with MRSA had blepharoconjunctivitis, 2.4% had cellulitis, 2.4% had dacryocystitis, 14.6% had keratitis, and 2.4% had endophthalmitis. The diagnoses associated with MSSA were not statistically different. A total of 63.6% of MRSA isolates were sensitive to bacitracin, 100% to vancomycin, 14.8% to ciprofloxacin, 14.8% to erythromycin, 97.7% to sulfisoxazole, and 93.2% to tetracycline.


CONCLUSIONS
MRSA has become a more common ocular pathogen but, as with MSSA, causes mild disease. MRSA should be treated with vancomycin.
F I Proctor Foundation, University of California, San Francisco, CA 94143, USA. jfleigh@gmail.com
Julie
J
Freidlin
Nisha
N
Acharya
Thomas M
TM
Lietman
Vicky
V
Cevallos
John P
JP
Whitcher
Todd P
TP
Margolis
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001762:Blepharitis / Q000382:microbiology; D002140:California / Q000453:epidemiology; D003231:Conjunctivitis / Q000382:microbiology; D003430:Cross-Sectional Studies; D003607:Dacryocystitis / Q000382:microbiology; D009877:Endophthalmitis / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000382:microbiology*; D006801:Humans; D007634:Keratitis / Q000382:microbiology; D008712:Methicillin / Q000627:therapeutic use; D016106:Methicillin Resistance; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents; D008712:Methicillin