EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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May 2012 Perioperative pharmacology February 2011 EW FEATURE 39 1514) found that one-third of cataract surgery patients were colo- nized with Staphylococcus on their ocular or periocular surface. Staphy- lococcus epidermidis (MRSE) was the most frequently isolated organism at 62.9%, followed by MRSA at 14%. "Methicillin-resistant Staphylo- coccal isolates were found in 157 of 399 (39.3%) patients, the majority (89.2%) of whom were non-health- care workers," stated the study. "Pa- tients without exposure to health care environments are as likely as health care workers to be colonized with methicillin-resistant organ- isms." "There were [patients] walking in for routine surgery, not sick peo- ple coming from intensive care units," said Terrence P. O'Brien, M.D., professor of ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami. "Ten years ago, we'd have a heightened awareness to someone who had been in an intensive care unit, burn unit, or nursing home. Those people we were aware of. What this study is telling us is we have to assume that one-third to half of [all] our patients are harbor- ing these resistant strains." Growing resistance It's no secret that antibiotic resist- ance is a growing problem in the medical world due to an unfortunate combination of factors. Some of the reasons, such as excessive antibiotic use agriculturally, are out of physi- cians' control. But what's causing this resistance is frequently debated. "It seems like ophthalmology is not promoting the resistance. It's just a general overall bacterial resist- ance that's finally going to the eye," said Francis S. Mah, M.D., medical director, Charles T. Campbell Oph- thalmic Microbiology Laboratory, University of Pittsburgh School of Medicine. Antibiotic resistance didn't used to be a huge concern in ophthalmol- ogy because of the advantage that came with applying a high concen- tration of antibiotic drops directly to the eye. "Over time the situation has changed," said Dr. O'Brien. "[Oph- thalmologists] have realized that this is something we have to be aware of and pay attention to. We have to be more savvy in evaluating data on Whether you're just beginning or experienced in cataract and refractive surgery, ASCRS is the professional society that's right for every stage of your career. Established Anterior Segment Ophthalmologists Mid-career is perhaps the most challenging period for today's ophthalmologist. The clinical and technological changes have never come faster and the regulatory concerns have never been greater. ASCRS' Annual Sympo- sium and Winter Update offer the education and networking needed to help your practice excel, and our ASCRS MediaCenter provides targeted online content addressing the issues most pressing to you. ASCRS' monthly Journal of Cataract and Refractive Surgery reports on all aspects of anterior segment surgery, and our meetings are focused, well-organized, and highly interactive. eyeCONNECT, ASCRS' online clinical service, lets you share questions and answers with like-minded peers in a private and supportive environment. ASCRS' commitment to fostering excellence through collaborative exchange is unmatched by any other ophthalmic organization. Join ASCRS today! The Society for Surgeons AMERICAN SOCIETY OF CATARACT AND REFRACTIVE SURGERY 4000 Legato Road, Suite 700, Fairfax, VA 22033 • 703-591-2220 • www.ASCRS.org antimicrobial susceptibility and resistance patterns." Recently there has been a steady decline in the susceptibility of com- monly recovered ocular isolates to the most frequently used antibiotics, particularly to the fluoroquinolone class, said Dr. O'Brien. The Bascom Palmer laboratory has seen a rise in resistance of ocular isolates that cause external infec- tions like blepharitis, conjunctivitis, corneal infections, and endoph- thalmitis since the turn of the mil- lennium. continued on page 42 An ASCRS Membership For every stage of your career