Periorbital MRSA infections may be increasing

Results of a recent small study suggest that periorbital infections secondary to methicillin-resistant Staphylococcus aureus (MRSA) may be on the rise.

After an increase in these infections was noticed in clinical practice, Brett Levinson, MD, University of Maryland School of Medicine, and colleagues conducted a retrospective chart review and identified 15 patients who had presented to either the University of Maryland Medical Center or the Baltimore Veterans Administration Medical Center with periorbital infections over a 24-month period.

They identified 15 patients and found that 11 had an MRSA infection, 2 had methicillin-sensitive S. aureus (MSSA), and 2 had unknown cultures. Among patients who were not hospitalized at the time of their diagnosis, many had known risk factors such as intravenous drug use, incarceration, or HIV. Six patients had hospital-associated MRSA.

All of the infections were sensitive to vancomycin, but resistance to numerous other drugs was found in patients with both hospital-associated and community-associated infections. Both strains were resistant to gatifloxacin.

The cases reviewed in this study were only those that were treated at one of the study hospitals, and it is likely that the incidence was higher in the community, Dr. Levinson said. He recommended that clinicians be alert for MRSA in patients with periorbital infections and be familiar with the local drug resistance profile, which may differ from community to community.

Dr. Levinson is serving a fellowship at Wills Eye Hospital, Philadelphia.