2009 OMIG, Abstract 13

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Persistence of MRSA on Ocular Surface following Primary Infection.
D. Miller¹, D. Almeida², E. Alfonso¹
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida¹, Department of Ophthalmology, Queen’s University, Kingston, Ontario²

Purpose: To document the prevalence and persistence of MRSA colonization following primary ocular surface infections
Methods: Culture positive cases (N=23,793) were reviewed and repeat/persistent cases of MRSA identified and characterized by location and source over a 20 year period. Co-pathogens and trends in MRSA rates were also compiled.
Results:  Prevalence of MRSA among all Staphylococcus infections (N=3236) rose from 7.6% at baseline (1990-1994) to 34.6% during 2004-2009.  The general MRSA (N=669) rate increased by at least three fold among all ocular isolates. A cohort of 61 patients (9.1%) had repeat positive MRSA cultures and 67% remained colonized after multiple treatment regimens. Sixty seven percent (N=41) of persistent isolates were from patients with prior healthcare exposures; outpatient clinics (52.4%), ambulatory care/OR (11.8%) and inpatients (3.3%). Repeat isolates were more frequently recovered from the conjunctiva (N=26, 42.6%) and cornea (N=18, 29.5%). Nasal cultures from three patients with repeat cultures also revealed MRSA.  Co-pathogens among this cohort was 70.5% (N=43).
 Conclusions: Persistent and increasing recovery of MRSA from ocular surface could serve as a reservoir and transmission foci for post operative infections following, lasik, cataract and other ocular surgeries
Disclosure code: N