Methicillin resistance of Staphylococcus species among health care and nonhealth care workers undergoing cataract surgery

Randall Olson, Eric Donnenfeld, Frank A. Bucci, Francis W. Price, Michael Raizman, Kerry Solomon, Uday Devgan, William Trattler, Steven Dell, R. Bruce Wallace, Michelle Callegan, Heather Brown, Peter J. McDonnell, Taryn Conway, Rhett M. Schiffman, David A. Hollander

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The purpose of this study is to characterize the bacterial flora of the ocular and periocular surface in cataract surgery patients and to determine the prevalence of methicillin resistance among staphylococcal isolates obtained from health care workers (HCWs) and non-HCWs. Methods: In this prospective, multicenter, case series study, eyelid and conjunctival cultures were obtained from the nonoperative eye of 399 consecutive cataract patients on the day of surgery prior to application of topical anesthetics, antibiotics, or antiseptics. Speciation and susceptibility testing were performed at the Dean A. McGee Eye Institute. Logistic regression was utilized to evaluate whether any factors were significant in predicting the presence of methicillin-resistant staphylococcal isolates. Results: Staphylococcus epidermidis (62.9%), followed by S. aureus (14.0%), was the most frequently isolated organism. Methicillin-resistant S. epidermidis accounted for 47.1% (178/378) of S. epidermidis isolates, and methicillin-resistant S. aureus accounted for 29.5% (26/88) of S. aureus isolates. Methicillin-resistant staphylococcal isolates were found in 157 of 399 (39.3%) patients, the majority (89.2%) of whom were non-HCWs. The likelihood of being colonized with methicillin-resistant organisms increased with age (odds ratio [OR], 1.27; 95% confidence interval [CI]: 1.02-1.58; P = 0.04) but decreased with diabetes (OR, 0.51; 95% CI: 0.29-0.89; P = 0.02). Being a HCW (OR, 1.25; 95% CI: 0.61-2.58; P = 0.54) was not a risk factor for colonization with methicillin-resistant organisms. Conclusion: Patients without exposure to health care environments are as likely as HCWs to be colonized with methicillin-resistant organisms. Increasing methicillin resistance with age may partially explain the increased risk of endophthalmitis reported with older age.

Original languageEnglish (US)
Pages (from-to)1505-1514
Number of pages10
JournalClinical Ophthalmology
Volume4
Issue number1
DOIs
StatePublished - 2010

Keywords

  • Age
  • Bacterial flora
  • Cataract surgery
  • Methicillin resistance
  • Ocular and periocular surface
  • Staphylococci

ASJC Scopus subject areas

  • Ophthalmology

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