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Conjunctivitis associated with methicillin-resistant Staphylococcus aureus in a long-term-care facility
Purpose:
To determine the clinical characteristics of conjunctivitis associated with methicillin-resistant Staphylococcus aureus (MRSA) in a long-term-care facility.
Patients And Methods:
We followed 20 episodes of MRSA-associated conjunctivitis in 19 patients occurring over a three-year period in a 432-bed long-term-care facility.
Results:
The clinical picture was that of a purulent conjunctivitis from which MRSA was isolated on culture. Seventeen patients had severe, pre-existing neurologic impairment. Nine were colonized by MRSA before the onset of conjunctivitis. Seven of eight patients treated with oral ciprofloxacin and all eight patients treated with topical vancomycin showed clinical resolution of conjunctivitis. Persistence of MRSA colonization at a variety of anatomic sites was noted after therapy following 14 episodes.
Conclusion:
MRSA-associated conjunctivitis in our long-term-care facility was notable for its occurrence in patients with severe neurologic disease. Both oral ciprofloxacin and topical vancomycin therapy were associated with clinical resolution. Since MRSA is endemic in many long-term-care facilities, it is likely that MRSA-associated conjunctivitis will be increasingly recognized.
Insights
Conjunctivitis linked to methicillin-resistant Staphylococcus aureus (MRSA) commonly affects patients with severe neurologic impairment in long-term care facilities. Both oral ciprofloxacin and topical vancomycin effectively treated MRSA conjunctivitis, though MRSA colonization often persisted.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Geriatric Medicine
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen in healthcare settings.
- Conjunctivitis is an ocular infection that can be caused by various microorganisms.
- Long-term-care facilities (LTCFs) are prone to endemic infections due to vulnerable patient populations.
Purpose of the Study:
- To characterize the clinical presentation of conjunctivitis caused by MRSA.
- To identify risk factors and outcomes associated with MRSA conjunctivitis in an LTCF setting.
Main Methods:
- A retrospective study followed 20 episodes of MRSA-associated conjunctivitis in 19 patients over three years.
- Data collected included patient demographics, clinical signs, MRSA colonization status, and treatment outcomes.
Main Results:
- The study identified purulent conjunctivitis as the primary clinical manifestation of MRSA infection.
- Seventeen patients (89%) had severe pre-existing neurologic impairment, and nine (47%) were previously colonized with MRSA.
- Clinical resolution was achieved in 7 of 8 patients treated with oral ciprofloxacin and all 8 patients treated with topical vancomycin.
Conclusions:
- MRSA-associated conjunctivitis predominantly affects individuals with severe neurologic conditions in LTCFs.
- Both oral ciprofloxacin and topical vancomycin demonstrated efficacy in resolving MRSA conjunctivitis.
- Increased recognition of MRSA conjunctivitis is anticipated given its endemic nature in LTCFs.