Endogenous Methicillin-Resistant Staphylococcus Aureus Endophthalmitis

Abstract

This series represents the largest single-institution report on endogenous methicillin-resistant S. aureus endophthalmitis and associated outcomes. Although previously reported cases cited poor visual outcomes and high enucleation rates, the authors' current series shows that retinal detachments are common and enucleation rates are low.

Endophthalmitis

“…The association between S. aureus EE and the prolonged use of indwelling prosthetics has been reported in diabetics and patients with other underlying immunocompromise with increasing frequency (Jackson et al, 2003;Major et al, 2010;Ness and Schneider, 2009;Nixdorff et al, 2009;Okada et al, 1994). S. aureus causes the majority of the cases of EE in Western countries and Europe (Ho et al, 2011). The emergence of lineages resistant to methicillin in the 1960s has prompted a public health crisis due to the difficulty in treating methicillin-resistant S. aureus (MRSA) infections and the increasing trend of infection among individuals with fully competent immune systems.…”

Methicillin-Resistant Staphylococcus aureus and the Eye: Current Concepts and Management Strategies

“…The MRSA prevalence rate increased 12.1 % during the 5-year period (from 29.5 % in 2000 to 41.6 % in 2005) [114]. Amato et al [93] Small case series (based on microbiology results or drug trials) Shanmuganathan et al [123] Rutar et al [91] Adebayo et al [124] Lichtinger et al [95] Sotonzono et al [118] Case reports site-specific Lacrimal system Kotlus et al [90] Rutar [107] Kubal and Garibaldi [105] Chandravanshi et al [106] Gould et al [125] Conjunctiva Tarabishy et al [85] Cimolai [61] Ikeda et al [119] Mantadakis et al [113] Cellulitis Mehra et al [98] Charalampidou et al [99] Juthani et al [101] Vaska et al [104] Soon [100] Mathias et al [102] Endophthalmitis Deramo et al [96] Major et al [97] Ursea et al [126] Ho et al [86] Basu et al [62] Keratitis Sotozono et al [67] Lee et al [69] Chou et al [65] Post-surgical case reports Cataract surgery Cosar et al [75] Tang et al [70] Retinal surgery Oshima et al [68] Feiz and Redline [72] Rich et al [74] Pterygium surgery Lee et al [73] Curr…”

“…Reports of MRSA ophthalmic infections are numerous in the literature. They are more commonly seen in patients in neonatal ICUs [61][62][63], in post-ocular surgical patients [64][65][66][67][68][69][70][71][72][73][74][75], among healthcare workers [76,77] after corneal refractive surgery [77][78][79][80][81][82][83][84], in hospitalized pediatric patients [85], and in patients with chronic medical disease, immuno-suppression, or immunodeficiency [70,86].…”

Ocular Complications of Endocarditis

“…(33,34) Patients may require enucleation to eradicate a blind and painful eye. (38) Mortality is related to the patient's comorbidities and the underlying medical problem, especially when considering the etiology of hematogenous spread in endogenous infections. (39,40) …”

“…(115,116) The benefits of vitreous tap outweigh the benefits of vitrectomy for anterior focal or diffuse and posterior focal cases with endogenous endophthalmitis. (38) In general vitrectomy is indicated in cases of posterior diffuse cases with prominent vitreous involvement, and also for cases showing progressive disease despite intensive medical therapy. (116) In these cases small gauge vitrectomy is effective in clearing the vitreous from the inflammatory debris, cells and mediators.…”