Related Experiment Videos
Methicillin-resistant Staphylococcus aureus infections after scleral buckling procedures for retinal detachments
Objective:
To determine the incidence and the clinical course of methicillin-resistant Staphylococcus aureus as a cause of acute-onset infections in patients with atopic dermatitis after a scleral buckling procedures.
Design:
A retrospective chart review.
Participants:
Two hundred eighty-seven patients (293 eyes) who underwent scleral buckling procedures to treat rhegmatogenous retinal detachments at either Osaka Rosai Hospital or Osaka University Medical School between July 1, 1995, and June 30, 1997, participated. Of these, 32 eyes (10.9%) were associated with atopic dermatitis.
Intervention:
Demographic and clinical data were abstracted from patients' medical records.
Main Outcome Measures:
The incidence, clinical features, and management of postoperative infections associated with methicillin-resistant S. aureus were studied.
Results:
Methicillin-resistant S. aureus infection after scleral buckling procedures was identified in 6 (18.8%) of 32 eyes of patients with atopic dermatitis but in only 1 (0.4%) of the other 261 cases without atopic dermatitis (P < 0.001). The average interval from the scleral buckling procedures to the initial onset of infection was 8.3 +/- 9.1 days (range, 2-28 days). Bacterial infection and inflammation were controlled in four eyes by prompt removal of the infected buckle in combination with vancomycin administration. In the other three eyes, however, repeat intravitreous injections of vancomycin or emergent vitrectomies were required because of the development of endophthalmitis.
Conclusions:
Methicillin-resistant S. aureus is an important causative pathogen of scleral buckling infections, particularly in patients with retinal detachment associated with atopic dermatitis. Preoperative evaluation and intraoperative attention to contamination are recommended to prevent methicillin-resistant S. aureus infections in these patients.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) infections are a significant risk after scleral buckling surgery, especially in patients with atopic dermatitis. Prompt treatment is crucial to manage these serious postoperative infections.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Dermatology
Background:
- Scleral buckling is a surgical procedure for retinal detachment.
- Atopic dermatitis is a chronic inflammatory skin condition.
- Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of hospital-acquired infections.
Observation:
- A retrospective chart review analyzed 287 patients undergoing scleral buckling.
- 32 eyes (10.9%) were associated with atopic dermatitis.
- MRSA infections occurred in 18.8% of atopic dermatitis patients versus 0.4% of others.
Findings:
- MRSA caused acute-onset infections in patients with atopic dermatitis post-scleral buckling.
- Infections appeared 2-28 days post-surgery.
- Four cases resolved with buckle removal and vancomycin; three required further intervention for endophthalmitis.
Implications:
- MRSA is a key pathogen in scleral buckling infections, particularly in atopic dermatitis patients.
- Preoperative assessment and intraoperative sterile techniques are vital.
- Early detection and management can prevent severe outcomes like endophthalmitis.