Comparison of Methicillin-Sensitive Staphylococcus Epidermidis (MSSE) Keratits and Methicillin-Resistant Staphylococcus Epidermidis (MRSE) Keratitis

ABSTRACT

PURPOSE: To investigate the clinical features and treatment outcomes between methicillin-sensitive Staphylococcus epidermidis (MSSE) and methicillin-resistant Staphylococcus epidermidis (MRSE) keratitis groups. METHODS: A retrospective analysis of case series was conducted of all patients with keratitis caused only by Staphylococcus epidermidis from January 1997 through December 2008. Sex, age, history of trauma, systemic disease, previous ocular history, antibiotic sensitivity test results, and treatment outcomes were evaluated. Patients were categorized into two groups as MSSE and MRSE according to methicillin-sensitivity result, and a comparative analysis was performed. RESULTS: There were no significant differences in clinical features, such as risk factors or size or location of keratitis between the two groups. All MSSE and MRSE isolates were sensitive to vancomycin, moxifloxacin, and levofloxacin. All MSSE and 17%, 50%, 52%, and 57% of MRSE isolates were sensitive to cephalothin, norfloxacin, ciprofloxacin, and erythromycin, respectively (p < 0.05). There was no significant difference in visual acuity between the two groups. CONCLUSIONS: All MSSE and MRSE isolates were sensitive to vancomycin and to third- or fourth-generation fluoroquinolones In addition, approximately 50% of MRSE isolates were sensitive to norfloxacin and ciprofloxacin. There were no significant differences in clinical features of keratitis caused by MSSE versus those of MRSE isolates. Both keratitis groups had relatively good visual prognoses.