Two cases of corneal ulcer due to methicillin-resistant Staphylococcus aureus in high risk groups.
Considering the popular use of antibiotic-containing eyedrops in Korea, it is important to know the emerging antibiotic-resistant strains of bacteria before treating infectious eye diseases. This is especially important in high-risk groups because of the high incidence of resistant infections and the subsequent treatment requirements. We report two cases of methicillin-resistant Staphylococcus aureus (MRSA) corneal ulcers in high-risk groups. The first case involved a patient who had keratitis after using antibiotic- and steroid-containing eyedrops to treat a corneal opacity that developed after repeated penetrating keratoplasty. The second case involved a patient who used antibiotic-containing eyedrops and a topical lubricant on a regular basis for >1 month to treat exposure keratitis due to lagophthalmos. The second patient's problems, which included a persistent superficial infiltration, developed after brain tumor surgery. Both cases showed MRSA on corneal culture, and the corneal ulcers improved in both patients after the application of vancomycin-containing eyedrops. In conclusion, MRSA infection should be considered in corneal ulcers that have a round shape, mild superficial infiltration, and slow progression, especially in high-risk groups. This report includes descriptions of the characteristic features, antibiotic sensitivities, prevention, and successful treatment with vancomycin-containing eyedrops for MRSA corneal ulcers.
Lee
Kyung-Min
KM
Department of Ophthalmology and Visual Science, The Catholic University of Korea School of Medicine, Seoul, Korea.
Lee
Hyun-Soo
HS
Kim
Man-Soo
MS
D003315:Cornea / Q000382:microbiology* / Q000473:pathology; D003320:Corneal Ulcer / Q000175:diagnosis / Q000382:microbiology*; D003937:Diagnosis, Differential; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology*