Hugo Y Hsu1, John T Lind2, Darlene Miller2, Lili Tseng2. 1. From the Doheny Eye Center UCLA (Hsu), Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, and the Department of Ophthalmology (Tseng), Permanente Medical Group, Inc., Fresno, California; the Department of Ophthalmology and Visual Sciences (Lind), Washington University in Saint Louis School of Medicine, Saint Louis, Missouri; the Bascom Palmer Eye Institute (Miller), Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA. Electronic address: hhsu@doheny.org. 2. From the Doheny Eye Center UCLA (Hsu), Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, and the Department of Ophthalmology (Tseng), Permanente Medical Group, Inc., Fresno, California; the Department of Ophthalmology and Visual Sciences (Lind), Washington University in Saint Louis School of Medicine, Saint Louis, Missouri; the Bascom Palmer Eye Institute (Miller), Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Abstract
PURPOSE: To assess the risk factors for eyes of cataract surgery patients harboring oxacillin-resistant Staphylococcus species on the ocular surface. SETTING: Ambulatory surgical center, Saint Louis University, Saint Louis, Missouri, USA. DESIGN: Prospective in vitro laboratory study of a patient cohort. METHODS: Conjunctival cultures were obtained on the day of surgery from eyes scheduled for cataract surgery. Patients answered a questionnaire about risk factors that might lead to having oxacillin-resistant Staphylococcus organisms in their eyes. The factors tested were age, sex, race, recent systemic and topical antibiotic usage, recent hospitalization, and exposure to healthcare and institutional settings. Logistic regression analysis was performed. RESULTS: Of the 183 eyes cultured, 128 (70.0%) tested positive for Staphylococcus organisms, of which 70 (54.7%) were oxacillin-resistant. Only recent antibiotic usage was statistically significantly associated with the presence of oxacillin-resistant organisms (odds ratio, 8.2; 95% confidence interval, 2.2-30.5; P=.002). The other risk factors were not statistically significantly associated: age (P=.06), sex (P=.33), race (P=.34), recent hospitalization (P=.94), and exposure to healthcare and institutional settings (P=.10). CONCLUSIONS: Although the nonophthalmic literature has reported various risk factors for the harboring of oxacillin-resistant organisms, in the eyes in this study, only antibiotic usage within 30 days preoperatively was significantly associated with the colonization of oxacillin-resistant organisms on the ocular surface. This finding is important to ophthalmic surgeons when considering perioperative antibiotic prophylaxis. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
PURPOSE: To assess the risk factors for eyes of cataract surgery patients harboring oxacillin-resistant Staphylococcus species on the ocular surface. SETTING: Ambulatory surgical center, Saint Louis University, Saint Louis, Missouri, USA. DESIGN: Prospective in vitro laboratory study of a patient cohort. METHODS: Conjunctival cultures were obtained on the day of surgery from eyes scheduled for cataract surgery. Patients answered a questionnaire about risk factors that might lead to having oxacillin-resistant Staphylococcus organisms in their eyes. The factors tested were age, sex, race, recent systemic and topical antibiotic usage, recent hospitalization, and exposure to healthcare and institutional settings. Logistic regression analysis was performed. RESULTS: Of the 183 eyes cultured, 128 (70.0%) tested positive for Staphylococcus organisms, of which 70 (54.7%) were oxacillin-resistant. Only recent antibiotic usage was statistically significantly associated with the presence of oxacillin-resistant organisms (odds ratio, 8.2; 95% confidence interval, 2.2-30.5; P=.002). The other risk factors were not statistically significantly associated: age (P=.06), sex (P=.33), race (P=.34), recent hospitalization (P=.94), and exposure to healthcare and institutional settings (P=.10). CONCLUSIONS: Although the nonophthalmic literature has reported various risk factors for the harboring of oxacillin-resistant organisms, in the eyes in this study, only antibiotic usage within 30 days preoperatively was significantly associated with the colonization of oxacillin-resistant organisms on the ocular surface. This finding is important to ophthalmic surgeons when considering perioperative antibiotic prophylaxis. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.