Latest ASCRS survey finds MRSA has risen to top of list of infection culprits

CHICAGO — Methicillin-resistant Staphylococcus aureus has emerged as the most common infection occurring after LASIK and surface ablation procedures, according to survey results evaluating trends in infectious keratitis throughout 2007.

Terry Kim, MD, presented the results of the study here yesterday during Cornea Day, preceding the American Society of Cataract and Refractive Surgery annual meeting. The survey, sponsored by the ASCRS Corneal Clinical Committee, is an update to those presented in 2002 and 2005, and seeks to analyze the changes since the first survey was undertaken.

"Over the last 7 years of doing this survey, we have seen a marked decrease in the incidents of atypical mycobacteria causing these infections. However, over the last two surveys, we’ve seen an increase in Staphylococcus organisms causing these infections," Dr. Kim said.

Eric D. Donnenfeld, MD, one of the study’s co-authors, is scheduled to present the survey results again today, Saturday, April 5, at 4:33 pm in room 184A.

Dr. Kim said the survey, which was conducted by sending out e-mails to all ASCRS members, also showed that a larger percentage of infection cases were presenting within a week after surgery than in previous years.

Results further showed that the risk of infection was significantly greater with surface ablation procedures than with LASIK, and when performed with a keratome vs. a femtosecond laser.

"Possible explanations include better sterility with a single-use femtosecond laser cone and less epithelial abrasions," Dr. Kim said.

The survey also showed some positives consequences, including increased vigilance in recent years: In 2007, 84% of infectious cases were diagnosed at initial suspicion, compared to 2004, when most infectious cases were not diagnosed upon presentation.

"It is encouraging to see that the ASCRS Corneal Committee’s recommendation for managing these suspicious infiltrates seems to be getting across," Dr. Kim said.