Methicillin-resistant Staphylococcus aureus ocular infection: a 10-year hospital-based study

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Methicillin-resistant Staphylococcus aureus (MRSA) is a prevalent pathogen causing various infections.
• Ocular infections due to MRSA, both community-associated (CA-MRSA) and healthcare-associated (HA-MRSA), require characterization for effective management.
• Understanding demographic and clinical differences between CA-MRSA and HA-MRSA ocular isolates is crucial for targeted treatment strategies.

Purpose of the Study:

• To characterize patient demographics, clinical features, and antibiotic susceptibility of ocular infections caused by MRSA.
• To differentiate between community-associated (CA-MRSA) and healthcare-associated (HA-MRSA) isolates in ocular infections.
• To analyze the trends and resistance patterns of MRSA ocular infections over a 10-year period.

Main Methods:

• Retrospective, observational study of 519 patients with culture-proven S. aureus ocular infections.
• Data collection included patient demographics, clinical information, and diagnosis.
• Antibiotic susceptibility was determined using the disc diffusion method.

Main Results:

• MRSA accounted for 52.8% of S. aureus ocular infections, with CA-MRSA comprising 66.1% of MRSA isolates and showing an increasing trend.
• Patients with ocular CA-MRSA infections were younger, with more lid and lacrimal system disorders, but less keratitis, endophthalmitis, and wound infections compared to HA-MRSA.
• Both CA-MRSA and HA-MRSA isolates exhibited resistance to clindamycin and erythromycin; CA-MRSA showed greater susceptibility to sulfamethoxazole/trimethoprim.

Conclusions:

• Community-associated MRSA is a significant pathogen in ocular infections, with distinct demographic and clinical profiles compared to HA-MRSA.
• Both CA-MRSA and HA-MRSA ocular isolates demonstrated multi-drug resistance at a major referral hospital in Taiwan.
• Ophthalmologists in regions with high MRSA prevalence should be aware of these epidemiological findings for improved patient care.