TY - JOUR
T1 - Ocular flora and their antibiotic resistance patterns in the midwest
T2 - A prospective study of patients undergoing cataract surgery
AU - Hsu, Hugo Y.
AU - Lind, John T.
AU - Tseng, Lili
AU - Miller, Darlene
N1 - Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors have no proprietary or commercial interest(s) in materials discussed in this article. H.Y.H. and L.T. both worked in a clinical trial as co-investigators for Allergan, which paid their department for work performed as part of the clinical trial on bimatoprost 0.03%. J.T.L. has received lecturing/speakers bureau fees from Alcon Labs and Allergan. This study was supported in part by an unrestricted departmental grant from Research to Prevent Blindness Inc , New York, New York. Involved in design and conduct of the study (H.Y.H., L.T.); collection, management, analysis, and interpretation of the data (H.Y.H., J.T.L., L.T., D.M.); and preparation, review, or approval of the manuscript (H.Y.H., J.T.L., L.T., D.M.). This prospective study design was approved by the Institutional Review Boards of Saint Louis University. Specifically, the IRB of Saint Louis University approved the study design, the study protocol, the informed consent for participation in research, and the waiver/alteration of HIPAA authorization.
PY - 2013/1
Y1 - 2013/1
N2 - Purpose: To determine the spectrum of conjunctival flora and the antibiotic susceptibility profiles of patients undergoing cataract surgery at a Midwestern university. Design: Prospective in vitro laboratory investigation of a patient cohort. Methods: Conjunctival cultures were obtained from patients undergoing cataract surgery at a single ambulatory center on the day of surgery before the instillation of any ophthalmic medications. Isolates and antibiotic susceptibility profiles were identified using standard microbiological techniques. Results: A total of 183 eyes were cultured, yielding 225 isolates. Twenty-seven eyes (14.8%) showed no growth. Coagulase-negative staphylococci (CNS) were the most commonly isolated organisms (74.8%). Overall susceptibility was highest for gentamicin (94%), which was also true of the CNS isolates (95.0%). A total of 64.5% of CNS isolates were sensitive to ciprofloxacin; 30.1% of CNS isolates were resistant to ≥3 classes of antibiotics; 46.6% of CNS isolates were oxacillin-resistant, and they were more resistant to antibiotics than their oxacillin-sensitive counterparts (P <.001), including fluoroquinolones (P <.001). Among eyes with multiple CNS strains, 41.4% had different antibiotic susceptibility profiles even though they were the same species. Conclusions: Our cohort harbored organisms with similar rates of antibiotic resistance as elsewhere in the country, including oxacillin resistance; however, the rate of fluoroquinolone resistance was less than in other reports. A surprisingly large proportion of different CNS strains from the same eye harbored different antibiotic susceptibility profiles. Our in vitro results, along with those of other investigators, should prompt further dialogue regarding antibiotic of choice for perioperative surgical prophylaxis in ophthalmic surgery.
AB - Purpose: To determine the spectrum of conjunctival flora and the antibiotic susceptibility profiles of patients undergoing cataract surgery at a Midwestern university. Design: Prospective in vitro laboratory investigation of a patient cohort. Methods: Conjunctival cultures were obtained from patients undergoing cataract surgery at a single ambulatory center on the day of surgery before the instillation of any ophthalmic medications. Isolates and antibiotic susceptibility profiles were identified using standard microbiological techniques. Results: A total of 183 eyes were cultured, yielding 225 isolates. Twenty-seven eyes (14.8%) showed no growth. Coagulase-negative staphylococci (CNS) were the most commonly isolated organisms (74.8%). Overall susceptibility was highest for gentamicin (94%), which was also true of the CNS isolates (95.0%). A total of 64.5% of CNS isolates were sensitive to ciprofloxacin; 30.1% of CNS isolates were resistant to ≥3 classes of antibiotics; 46.6% of CNS isolates were oxacillin-resistant, and they were more resistant to antibiotics than their oxacillin-sensitive counterparts (P <.001), including fluoroquinolones (P <.001). Among eyes with multiple CNS strains, 41.4% had different antibiotic susceptibility profiles even though they were the same species. Conclusions: Our cohort harbored organisms with similar rates of antibiotic resistance as elsewhere in the country, including oxacillin resistance; however, the rate of fluoroquinolone resistance was less than in other reports. A surprisingly large proportion of different CNS strains from the same eye harbored different antibiotic susceptibility profiles. Our in vitro results, along with those of other investigators, should prompt further dialogue regarding antibiotic of choice for perioperative surgical prophylaxis in ophthalmic surgery.
UR - http://www.scopus.com/inward/record.url?scp=84871248506&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2012.06.024
DO - 10.1016/j.ajo.2012.06.024
M3 - Article
C2 - 22995030
AN - SCOPUS:84871248506
SN - 0002-9394
VL - 155
SP - 36-44.e2
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 1
ER -