Endogenous Methicillin-Resistant Staphylococcus Aureus (MRSA) Endophthalmitis: A Six-year Series at a Tertiary Care Center

ABSTRACT

Purpose

To investigate the clinical outcomes of methicillin-resistant Staphylococcus aureus (MRSA) endophthalmitis.

Methods

Clinical courses were reviewed for 17 eyes (15 patients) with endogenous MRSA endophthalmitis based on positive blood and vitreous culture or clinical suspicion between 2013 to 2019 at Duke University Hospitals.

Results

Of 17 eyes, initial VA ranged from 20/40 to light perception. Of 15 patients, 9 had predisposing risk factors for bacteremia. All eyes received intravitreal vancomycin, 13 also received ceftazidime, and 2 also received amikacin instead of ceftazidime. Nine eyes developed retinal detachment; 6 underwent vitrectomy. Final VA ranged from 20/20 to no light perception and was ≥20/200 in 8 eyes. Eleven eyes had improved VA, 2 eyes were unchanged, and 4 were worse.

Conclusions

This study is the largest series on endogenous MRSA endophthalmitis to date. Patients had a higher proportion of final VA ≥20/200, similarly high rate of RD, and fewer enucleations compared to prior reports.

KEYWORDS:

• Endogenous endophthalmitis
• endophthalmitis
• methicillin-resistant Staphylococcus aureus
• bacteremia
• MRSA endophthalmitis

Acknowledgments

We would like to thank the following individuals who contributed to the care of the patients in the present study: Dilraj Singh Grewal, MD, Prithvi Mruthyunjaya MD. Xi Chen, MD, Sophie Cai, MD, Wenlan Zhang, MD, Tamer H Mahmoud MD, Lejla Vajzovic, MD, Patrick Rafael Oellers, MD, Glenn J Jaffe, MD, Akshay S Thomas, MD, and Michael I Seider, MD.

Declaration of Interest

The authors report no conflict of interest.