MRSA Keratitis and Conjunctivitis: What Does It Mean Practically?

Abstract

This paper aims to review the epidemiology and clinical spectrum of two of the most common ophthalmic manifestations of methicillin-resistant Staphylococcus aureus (MRSA) infection, conjunctivitis, and keratitis. Recent data on antimicrobial resistance patterns and its clinical implications will be reviewed, as well as strategies for ophthalmologists to adequately treat infections and curtail the progress of resistance. There have been reports that the prevalence of MRSA ocular infections has been increasing and is associated with an increase in resistance to fluoroquinolones based on systemic standards. Notably, with community-acquired MRSA (CA-MRSA) on the rise, colonization and infection with MRSA is no longer exclusive to those with traditional risk factors. Key strategies including culture-directed treatment with potent antimicrobials, effective antimicrobial dosing, empirical treatment based on local trends, and utilization of antiseptic strategies and antibiotic cycling should be utilized by clinicians to limit the spread of MRSA ophthalmic infections.