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Persistence and Prevalence of MRSA on Ocular Surface following Primary MSSA/MRSA Infections

Persistence and Prevalence of MRSA on Ocular Surface following Primary MSSA/MRSA Infections Darlene Miller, DHSc, MPH, CIC David Almeida, MD, PhD Eduardo C. Alfonso, MD. The authors have no financial interest in the subject matter of this poster. Introduction.

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Persistence and Prevalence of MRSA on Ocular Surface following Primary MSSA/MRSA Infections

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  1. Persistence and Prevalence of MRSA on Ocular Surface following Primary MSSA/MRSA Infections Darlene Miller, DHSc, MPH, CIC David Almeida, MD, PhD Eduardo C. Alfonso, MD The authors have no financial interest in the subject matter of this poster.

  2. Introduction • Staphylococcus aureus remains the most common ocular pathogen recovered from ocular infections at our Institute. • Colonization and persistent S. aureus infections can lead to chronic inflammation and severe ocular surface disease. Ocular Sources-BPEI 1990-June 2009,

  3. Purpose • To document the prevalence and persistence of (MRSA) colonization following primary S. aureus infections. • To identify presister populations. • To document changes in in vitro susceptibility to vancomycin among patients with chronic MRSA infections.

  4. Methods • Review of all MRSA Culture Positive Cases - 1990-June 2009 • Colonizer= Patient with repeat MRSA positive culture after a treatment course of at least 10 days. • Patient Demographics • Age • Sex • Presenting Clinical Diagnosis • Review and comparison of Vancomycin MICs

  5. RESULTSMRSA Trends-All Ocular-1990-June 2009

  6. Prevalence of MRSA Colonization/Persistence

  7. Persistent MRSA Colonization Profile 22%, 11/50 had 3 or more positive cultures

  8. Demographics-Age/Sex (N=50) • Female = 54% • Males = 46%

  9. Clinical Diagnosis-Persistent MRSA Colonizers (N=50)

  10. Change in Vancomycin MIC Among Repeat MRSA Isolates 24% increase in vancomycin MIC, (100% susceptible)

  11. Summary • MRSA rates increased from 8% at baseline (1990-1994) to 38% in the last 4.5 years (2005-June 2009). • Persistent MRSA colonization remain stable over the 19 year period (7.7%). • Persistent MRSA was more frequently recovered from conjunctivitis and women >60 yrs. • 24% of repeat MRSA isolates demonstrated increased Vancomycin MICs

  12. Clinical Relevance • Colonization or Persistent MRSA on the ocular surface can serve as: • Reservoir/foci for post surgical infections. • Antigenic trigger for increased/chronic inflammation. • Repeat or persistent MRSA isolation may impact in vivo efficacy of vancomycin.

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