TABLE 2
FROM:
External ocular infections due to methicillin-resistant Staphylococcus aureus (MRSA)
V A Shanmuganathan, M Armstrong, A Buller and A B Tullo
BACK TO ARTICLETable 2. Summary of studies looking at MRSA ocular infections
| AuthorYear Country of study | Type of study (no. of patients) | Type of MRSA infections | Treatment (topical unless stated otherwise) | Other details of note |
|---|---|---|---|---|
| Ribner21 1987 USA | Case series (1) | Conjunctivitis | Not specified | Retrospective study over 7 years characterising MRSA infections in a paediatric unit |
| Ross and Abate22 1990 USA | Case report (1) | Conjunctivitis | Vancomycin | Methicillin-resistant Staphylococcal epidermidis also isolated |
| Brennen and Muder13 1990 USA | Case series (19) | Conjunctivitis | Systemic ciprofloxacin, vancomycin | Outcome of 20 episodes of conjunctivitis in a long-term care unit. A total of 17 patients had severe neurological impairment. Nine were colonised with MRSA before the onset of conjunctivitis |
| Insler et al 23 1991 USA | Case reports (3) | Postoperative keratitis | Ciprofloxacin | |
| Eiferman et al 24 1991 USA | Case reports (3) | Keratitis | Vancomycin used only. Resistant to aminoglycoides | One patient was from a nursing home |
| Tazawa and Ooishi (In Japanese)8 1992 Japan | Case series (46) | Conjunctivitis, keratitis, endophthalmitis | Olfoxacin, minocycline, netilmicin, amikacin used. | 10-year analysis with increasing ofloxacin resistance over time |
| Muder et al 25 1993 USA | Case series (1) | Conjunctivitis | Vancomycin | Describes MRSA infections of healthcare workers |
| Mitsuda et al 26 1995 Japan | Case series (4) | Conjunctivitis | Ofloxacin | Describes all types of MRSA infections in three outbreaks in a neonatal nursery |
| Spindel et al 27 1995 USA | Case series (28) | Conjunctivitis | Not specified | All types of MRSA and methicillin-susceptible infections over 5 years in a 120-bed nursing home. Patients were typically debilitated. 62% of patients had an CVA |
| Jernigan et al 28 1996 USA | Case series (1) | Conjunctivitis | Vancomycin not stated if systemic or topical | Describes a 7-month outbreak of MRSA colonisation and infections in neonatal ITU |
| Saitoh A et al 29 1997 Japan | Case reports (2) | Endophthalmitis acute dacrocystitis | Vancomycin systemically | Describes methodology of dose adjustment in patients on systemic vancomycin treatment |
| Oshima et al 30 1999 Japan | Case series (7) | Scleral buckle infections Endophthalmitis | Vancomycin. Used via systemic, intravitreal and subconjunctival routes in cases of endophthalmitis | MRSA infections associated with patients with atopic dermatitis |
| Rubinfeld and Negvesky14 2001 USA | Case report (1) | Bilateral keratitis postlaser in situ keratomileusis | Tobramycin, vancomycin | Patient had positive culture of MRSA from nares and also had a previous MRSA infection following abdominal surgery |
| Horil et al 10 2001 Japan | Case series (6) | Conjunctivitis | Benzethonium chloride 0.02% solutions used | Patients were bed-ridden and came from a single stroke unit |
| Rudd and Moshirfar15 2001 USA | Case report (1) | Keratitis postlaser in situ keratomileusis | Vancomycin, gentamicin and ofloxacin | |
| Cosar et al 31 2001 USA | Case series (2) | Corneal wound infections postphacoemulsification | Vancomycin and tobramycin. Systemic levofloxacin | Describes case series of seven corneal wound infections postphacoemulsification |
| Forster et al 16 2002 Germany | Case report (1) | Keratitis postphotorefractive keratectomy | Systemic gentamicin and clindamycin. Topical erythromycin | Patient had postoperative bandage contact lens and given ofloxacin drops |
| Kubo et al 32 2002 Japan | Case reports (4) | Acute and chronic dacrocystitis | Povidone−iodine or vancomycin. One patient also had dibekacin sulphate | Patients were treated successfully with a dacryocystorhinostomy. Postoperative cultures taken from the nose and conjunctiva were negative for MRSA |
| Sotozono et al 6 2002 Japan | Case series (30) | Conjunctivitis, keratitis | Vancomycin, arbecakacin | Study also included methicillin-resistant Staphylococcus epidermidis |
| Fukuda et al 7 2002 Japan | Case series (74) | Conjunctivitis | Vancomycin, chloramphenicol | Investigated prevalence of MRSA and methicillin- resistant coagulase-negative Staphylococcus infections on the ocular surface |
| Donnenfeld et al 17 2003 USA | Case series (1) | Keratitis postphotorefractive keratectomy | Tobramycin until culture results were available; then vancomycin and ofloxacin | Case was bilateral |
