MRSA and cataract surgery – reflections for practice

MRSA and cataract surgery – reflections for practice

LF Porter1, RU Khan2, A Hannan3, SP Kelly11Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 2Departments of Microbiology, Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 3Haughton Thornley Medical Centers, NHS Tameside and Glossop, UKIntroduction: Postoperative bacterial endophthalmit...

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Autores principales: LF Porter, RU Khan2, A Hannan, et al
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2010
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Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/7c701b42022e4472abf7a11998ddc0e5
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spelling oai:doaj.org-article:7c701b42022e4472abf7a11998ddc0e52021-12-02T02:09:35ZMRSA and cataract surgery – reflections for practice1177-54671177-5483https://doaj.org/article/7c701b42022e4472abf7a11998ddc0e52010-10-01T00:00:00Zhttp://www.dovepress.com/mrsa-and-cataract-surgery-ndash-reflections-for-practice-a5521https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483LF Porter1, RU Khan2, A Hannan3, SP Kelly11Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 2Departments of Microbiology, Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 3Haughton Thornley Medical Centers, NHS Tameside and Glossop, UKIntroduction: Postoperative bacterial endophthalmitis is a devastating complication of cataract surgery. Methicillin-resistant Staphylococcus aureus (MRSA) endophthalmitis is rare. Recent debate over MRSA screening in United Kingdom (UK) National Health Service (NHS) hospital services has implications for cataract patients and ophthalmology services.Aims: To discuss issues for clinical practice as based on reflective experience at a UK district general NHS hospital in relation to care of MRSA-positive cataract patients.Methods: Retrospective case series and reflective practice.Results: Three cases presented highlight practice points around cataract patients colonized with MRSA. Known or determined MRSA-colonized patients should be treated with anti-microbial agents at time of cataract surgery known to be active against MRSA. Preventative treatment with intracameral vancomycin or intravenous teicoplanin alongside appropriate topical treatments may be of merit. Importantly fluoroquinolones, often prescribed by cataract surgeons, may have a selective effect favoring the proliferation of MRSA.Conclusion: MRSA screening may cause unnecessary delays in cataract care and may represent a patient safety concern in its own right. Patients colonized with MRSA may safely undergo cataract surgery provided there is no evidence of periorbital infection and provided appropriate infection control and antibiotic prophylaxis measures are used. The well-prepared cataract surgeon needs to be aware of developments in infection control and should liaise with local clinical microbiology colleagues in relation to bacterial resistance to antibiotics.Keywords: methicillin-resistant Staphylococcus aureus (MRSA), endophthalmitis, screening LF PorterRU Khan2A Hannanet alDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2010, Iss default, Pp 1223-1227 (2010)
institution DOAJ
collection DOAJ
language EN
topic Ophthalmology
RE1-994
spellingShingle Ophthalmology
RE1-994
LF Porter
RU Khan2
A Hannan
et al
MRSA and cataract surgery – reflections for practice
description LF Porter1, RU Khan2, A Hannan3, SP Kelly11Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 2Departments of Microbiology, Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 3Haughton Thornley Medical Centers, NHS Tameside and Glossop, UKIntroduction: Postoperative bacterial endophthalmitis is a devastating complication of cataract surgery. Methicillin-resistant Staphylococcus aureus (MRSA) endophthalmitis is rare. Recent debate over MRSA screening in United Kingdom (UK) National Health Service (NHS) hospital services has implications for cataract patients and ophthalmology services.Aims: To discuss issues for clinical practice as based on reflective experience at a UK district general NHS hospital in relation to care of MRSA-positive cataract patients.Methods: Retrospective case series and reflective practice.Results: Three cases presented highlight practice points around cataract patients colonized with MRSA. Known or determined MRSA-colonized patients should be treated with anti-microbial agents at time of cataract surgery known to be active against MRSA. Preventative treatment with intracameral vancomycin or intravenous teicoplanin alongside appropriate topical treatments may be of merit. Importantly fluoroquinolones, often prescribed by cataract surgeons, may have a selective effect favoring the proliferation of MRSA.Conclusion: MRSA screening may cause unnecessary delays in cataract care and may represent a patient safety concern in its own right. Patients colonized with MRSA may safely undergo cataract surgery provided there is no evidence of periorbital infection and provided appropriate infection control and antibiotic prophylaxis measures are used. The well-prepared cataract surgeon needs to be aware of developments in infection control and should liaise with local clinical microbiology colleagues in relation to bacterial resistance to antibiotics.Keywords: methicillin-resistant Staphylococcus aureus (MRSA), endophthalmitis, screening
format article
author LF Porter
RU Khan2
A Hannan
et al
author_facet LF Porter
RU Khan2
A Hannan
et al
author_sort LF Porter
title MRSA and cataract surgery – reflections for practice
title_short MRSA and cataract surgery – reflections for practice
title_full MRSA and cataract surgery – reflections for practice
title_fullStr MRSA and cataract surgery – reflections for practice
title_full_unstemmed MRSA and cataract surgery – reflections for practice
title_sort mrsa and cataract surgery – reflections for practice
publisher Dove Medical Press
publishDate 2010
url https://doaj.org/article/7c701b42022e4472abf7a11998ddc0e5
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AT rukhan2 mrsaandcataractsurgeryampndashreflectionsforpractice
AT ahannan mrsaandcataractsurgeryampndashreflectionsforpractice
AT etal mrsaandcataractsurgeryampndashreflectionsforpractice
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