These are the first cases of MRSA infectious keratitis following refractive surgery, the first reports of MRSA keratitis after refractive surgery in patients with no known exposure to a healthcare facility, the first report of MRSA keratitis after a laser in situ keratomileusis (LASIK) enhancement, and the first reports of MRSA keratitis after prophylaxis with fourth generation fluoroquinolones.
Colonization of MRSA has been found in 1.5% of the general population, but as many as 9.4% of those were exposed to a healthcare facility. However, strains of MRSA are emerging in the community. These so-called community strains tend to be resistant only to beta-lactam antibiotics, unlike the hospital strains, which usually demonstrate multiple drug resistance. Community-acquired MRSA is becoming a significant problem, with the prevalence of MRSA among community isolates expected to reach as high as 25% in the next decade.
The authors cite the case of a male nurse who underwent an "uneventful" bilateral LASIK procedure that resulted in 20/20 (right eye) and 20/70 (left eye) visual acuity. Within 2 weeks, he had developed an infection in his left eye that grew worse, despite treatment, until his vision was only 20/400. When the infection was cultured and found to be MRSA, his antibiotics were changed and his vision recovered to 20/200 over the next two weeks. The patient is awaiting further surgical treatment.
Writing in the article, Eric D. Donnenfeld, MD, advises that, "MRSA infectious keratitis is a potentially serious complication
Source:Elsevier Health Sciences