Microbiology and management of Staphylococcus aureus lacrimal system infections: A 10-year retrospective study.
<h4>Purpose</h4>To assess the in vitro efficacy of common antimicrobial agents used empirically for methicillin- resistant and sensitive Staphylococcus aureus (MRSA and MSSA) infections of the lacrimal system.<h4>Methods</h4>A retrospective review of culture-proven S. aureus...
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Public Library of Science (PLoS)
2024-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0314366 |
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| author | Niloufar Bineshfar Kevin D Clauss Wendy W Lee Darlene Miller |
| author_facet | Niloufar Bineshfar Kevin D Clauss Wendy W Lee Darlene Miller |
| author_sort | Niloufar Bineshfar |
| collection | DOAJ |
| description | <h4>Purpose</h4>To assess the in vitro efficacy of common antimicrobial agents used empirically for methicillin- resistant and sensitive Staphylococcus aureus (MRSA and MSSA) infections of the lacrimal system.<h4>Methods</h4>A retrospective review of culture-proven S. aureus isolates retrieved from lacrimal system samples collected between January 2013-December 2022 was performed. Microbiologic characteristics such as in vitro susceptibility as well as clinical characteristics including history of recent ocular surgery, presence of lacrimal biomaterial implant, anti-microbial regimen, and treatments outcome were collected.<h4>Results</h4>One hundred and sixteen S. aureus isolates (patients = 116) were identified. Thirty-one (27.4%) and 22 (19.5%) patients had recent ocular procedure and lacrimal intubation, respectively. Fifty (44.2%) patients received a combination of oral and topical antibiotics as first line of treatment. The most common empirically utilized antibiotics were β-lactams (38.9%) and polymyxin B/ trimethoprim (31.0%). The antibiotic regimen was changed at least once in 20.5% of patients due to ineffectiveness. Of the patients with positive cultures from the lacrimal excretory apparatus, 37.3% underwent surgery as part of the treatment approach. Of all isolates identified 44.8% were MRSA. Among the fluoroquinolones, the resistance rate was 38.8% for ciprofloxacin and 30.4% for moxifloxacin, with significantly higher resistance rates in MRSA (P-value <0.0001). The resistance rates for trimethoprim/sulfamethoxazole (TMP/SXT) and gentamicin were 8.6% and 3.4%, retrospectively.<h4>Conclusions</h4>There is low in vitro efficacy of commonly used antimicrobials such as β-lactams and fluoroquinolones in our study population; thus, we recommend opting for trimethoprim/sulfamethoxazole and gentamicin for systemic and topical single-agent treatments. |
| format | Article |
| id | doaj-art-33d2a5ae855242e09556b62d371a2160 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-33d2a5ae855242e09556b62d371a21602025-08-20T01:53:22ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011911e031436610.1371/journal.pone.0314366Microbiology and management of Staphylococcus aureus lacrimal system infections: A 10-year retrospective study.Niloufar BineshfarKevin D ClaussWendy W LeeDarlene Miller<h4>Purpose</h4>To assess the in vitro efficacy of common antimicrobial agents used empirically for methicillin- resistant and sensitive Staphylococcus aureus (MRSA and MSSA) infections of the lacrimal system.<h4>Methods</h4>A retrospective review of culture-proven S. aureus isolates retrieved from lacrimal system samples collected between January 2013-December 2022 was performed. Microbiologic characteristics such as in vitro susceptibility as well as clinical characteristics including history of recent ocular surgery, presence of lacrimal biomaterial implant, anti-microbial regimen, and treatments outcome were collected.<h4>Results</h4>One hundred and sixteen S. aureus isolates (patients = 116) were identified. Thirty-one (27.4%) and 22 (19.5%) patients had recent ocular procedure and lacrimal intubation, respectively. Fifty (44.2%) patients received a combination of oral and topical antibiotics as first line of treatment. The most common empirically utilized antibiotics were β-lactams (38.9%) and polymyxin B/ trimethoprim (31.0%). The antibiotic regimen was changed at least once in 20.5% of patients due to ineffectiveness. Of the patients with positive cultures from the lacrimal excretory apparatus, 37.3% underwent surgery as part of the treatment approach. Of all isolates identified 44.8% were MRSA. Among the fluoroquinolones, the resistance rate was 38.8% for ciprofloxacin and 30.4% for moxifloxacin, with significantly higher resistance rates in MRSA (P-value <0.0001). The resistance rates for trimethoprim/sulfamethoxazole (TMP/SXT) and gentamicin were 8.6% and 3.4%, retrospectively.<h4>Conclusions</h4>There is low in vitro efficacy of commonly used antimicrobials such as β-lactams and fluoroquinolones in our study population; thus, we recommend opting for trimethoprim/sulfamethoxazole and gentamicin for systemic and topical single-agent treatments.https://doi.org/10.1371/journal.pone.0314366 |
| spellingShingle | Niloufar Bineshfar Kevin D Clauss Wendy W Lee Darlene Miller Microbiology and management of Staphylococcus aureus lacrimal system infections: A 10-year retrospective study. PLoS ONE |
| title | Microbiology and management of Staphylococcus aureus lacrimal system infections: A 10-year retrospective study. |
| title_full | Microbiology and management of Staphylococcus aureus lacrimal system infections: A 10-year retrospective study. |
| title_fullStr | Microbiology and management of Staphylococcus aureus lacrimal system infections: A 10-year retrospective study. |
| title_full_unstemmed | Microbiology and management of Staphylococcus aureus lacrimal system infections: A 10-year retrospective study. |
| title_short | Microbiology and management of Staphylococcus aureus lacrimal system infections: A 10-year retrospective study. |
| title_sort | microbiology and management of staphylococcus aureus lacrimal system infections a 10 year retrospective study |
| url | https://doi.org/10.1371/journal.pone.0314366 |
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