title: Nasal and conjunctival screening prior to refractive surgery: an observational and cross-sectional study.
abstract: To investigate bacterial flora of clinically healthy conjunctiva and nasal cavity among patients prior to refractive surgery, as well as the characteristics of patients with methicillin-resistant Staphylococcus aureus (MRSA) colonisation.
  
  
  
  Observational and cross-sectional study.
  
  
  
  A single-centre study in Japan.
  
  
  
  120 consecutive patients pre-refractive surgery.
  
  
  
  Samples were obtained from the right conjunctival sac and the nasal cavity of 120 consecutive patients prior to refractive surgery and were then measured for the levels of the minimum inhibitory concentration (MIC) of antibiotics. Patients were interviewed regarding their occupation, family living situation and any personal history of atopic dermatitis, asthma, smoking or contact lens wear.
  
  
  
  Propionibacterium acnes (P. acnes) (32.5%) and Staphylococcus epidermidis (4.2%) were detected from the conjunctival sac. S. epidermidis was the most commonly isolated (68.3%) in the nasal cavity. Of the 30 patients (25.0%) with colonisation by S. aureus, 2 patients, both of whom were healthcare workers with atopic dermatitis, were found to be positive for MRSA in the nasal cavity. A history of contact lens wear, asthma or smoking, as well as patient gender and age, was not associated with MRSA colonisation.
  
  
  
  There were only 2 patients who were colonised with MRSA, both of whom were healthcare workers with atopic dermatitis. P. acnes was predominantly found in the conjunctival sac. Further study is needed to investigate the involvement between nasal and conjunctival flora, and risk factors for infectious complications.
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan Baptist Eye Clinic, Kyoto, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kitazawa
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Chie
authors.initials: C
authors.lastname: Sotozono
authors.affiliation: Research Foundation for Microbial Diseases of Osaka University, Suita, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Sakamoto
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Sasaki
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Hieda
authors.affiliation: Baptist Eye Clinic, Kyoto, Japan.
authors.forename: Toshihide
authors.initials: T
authors.lastname: Yamasaki
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kinoshita
mesh_terms: D000328:Adult; D002353:Carrier State / Q000175:diagnosis* / Q000382:microbiology*; D003228:Conjunctiva / Q000382:microbiology*; D003352:Corynebacterium / Q000302:isolation & purification; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000150:complications; D005260:Female; D006282:Health Personnel; D006801:Humans; D007564:Japan; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D009296:Nasal Cavity / Q000382:microbiology*; D011300:Preoperative Care; D011425:Propionibacterium acnes / Q000302:isolation & purification; D054140:Refractive Surgical Procedures / Q000379:methods*; D012307:Risk Factors; D013212:Staphylococcus epidermidis / Q000302:isolation & purification
keywords: LASIK; MRSA; infectious keratitis; nasal colonization; refractive surgery