June 5, 2009 Since bacteria mutate frequently and become resistant to new antibiotics, ophthalmic researchers are on a continuous quest to identify the worst offenders and best treatments. Infections occur rarely in LASIK patients, but data show rates are slowly rising.
A recent study at Yonsei University College of Medicine, South Korea, evaluated infection risk in 105 patients using eye surface (conjunctiva) swabs taken immediately before LASIK or similar refractive surgery to measure preexisting bacteria.
Coagulase-negative staphylococci (CNS) was found in 84.9 percent of the cultures grown from the swab samples, and 31.4 percent was antibiotic (methicillin)-resistant. In other studies over the past decade the incidence of resistant CNS was less than two percent. This significant increase suggests that resistant strains are spreading through community contact and not only through surgical units, the researchers said.
The community-based spread of infections like CNS and methicillin-resistant staphylococcus aureus (MRSA) is raising concern world-wide, including in the United States. Lead researcher Kyoung Yul Seo, M.D., and colleagues used five fluroquinolone antibiotics (three newer generation and two older) to treat the bacteria in the culture samples. The most effective was the newest fluroquinolone approved by the U.S. Food and Drug administration. Dr. Seo thinks using the newer fluroquinolones as initial treatment may limit bacterias' ability to generate resistant mutations.
"Since resistant CNS is now widespread, it makes sense to develop ophthalmic agents using the newest fluroquinolones and to consider their use after refractive surgery to attempt to reduce infections, " Dr. Seo said.
This research was published in the June issue of Ophthalmology, the journal of the American Academy of Ophthalmology.
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