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Trend for methicillin resistance in ocular isolates remains high

Issue: November 25, 2016

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CHICAGO — Methicillin resistance among both Staphylococcus aureus and coagulase-negative staphylococci remains high and the “issue is not going away,” a speaker here said in a report of a 10-year analysis of antimicrobial trends.

“Methicillin resistance has not gone to zero, nor did we expect it to,” Penny A. Asbell, MD, FACS, MBA, said at the American Academy of Ophthalmology meeting.

In the analysis, Asbell and colleagues examined antibiotic resistance profiles of ocular staphylococcal and pneumococcal bacterial isolates collected in the Ocular TRUST and ARMOR studies to evaluate resistance trends.

Of more than 5,000 isolates analyzed, 1,220 were from the Ocular TRUST (2006-2008) and 4,226 were from the ARMOR study (2009-2015). Asbell and colleagues found 38% of 1,991 Staphylococcus aureus isolates were methicillin-resistant, 50% of 1,456 coagulase-negative staphylococci (CoNS) isolates were methicillin-resistant, and 34% of 789 Streptococcus pneumoniae isolates were azithromycin-resistant.

“Methicillin resistance is common among S. aureus and CoNS, but may be decreasing a little bit,” Asbell said, but whether this is an ongoing trend can only be determined by continued surveillance.

The S. aureus isolates, including the methicillin-resistant isolates, were least susceptible to azithromycin from among the topical agents tested and were most susceptible to trimethoprim, according to Asbell.

“[However], every drug has some resistant organisms, so it’s hard to find one where you’re going to be 100% home-free,” she said.

For CoNS, the isolates were again least susceptible to azithromycin.

“The good news for S. pneumoniae is we see pretty good, nearly 100% [susceptibility] with the fluoroquinolones that were tested,” Asbell said. Resistance to azithromycin, however, nearly doubled over the 10-year analysis period. – by Patricia Nale, ELS

Reference:

Asbell PA. Antimicrobial susceptibility in ocular isolates: From TRUST to ARMOR. Presented at: American Academy of Ophthalmology annual meeting; Oct. 14-18, 2016; Chicago.

Disclosures: Asbell reports no relevant financial disclosures.