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Despite rise in MRSA rates in refractive surgery patients, consensus has not been reached on prophylaxis
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CHICAGO — The prevalence of ocular disease due to methicillin-resistant Staphylococcus aureus is on the rise, especially in postoperative refractive surgery, according to a physician speaking here.
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"MRSA [methicillin-resistant Staphylococcus aureus] infections are changing from a primarily hospital-acquired infection to a community-acquired disease process," said Vahid Feiz, MD, who spoke during Cornea Day held before the American Society of Cataract and Refractive Surgery meeting.
According to a 2004 survey on infectious keratitis after refractive surgery, MRSA accounted for 61% of post-LASIK surgery infections.
Dr. Feiz suggested that broad-spectrum antibiotic consumption might have helped to develop resistance. He cited a relationship between the growing use of macrolides, cephalosporins and quinolones and the rate of new infections in hospitals.
Practitioners have not agreed upon an ocular prophylaxis measure to prevent MRSA in ocular surgery, Dr. Feiz noted.
"Preoperative antiseptics seem to be the most effective prophylactive measure," he said, adding that povidine iodine solution has the highest success rate. Use of preoperative nasal mupirocin ointment or oral linezolid in high-risk patients may also be considered, Dr. Feiz said.