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Analysis of risk factors for fluoroquinolone resistance in ocular flora of patients undergoing cataract surgery

Poster Details

First Author: S.Choi SOUTH KOREA

Co Author(s):                  

Abstract Details


To determine risk factors associated with fluoroquinolone resistance in ocular flora of patients undergoing cataract surgery.


Retrospective, in vitro culture study


Conjunctival cultures were obtained from patients undergoing cataract surgery at VHS medical center on the day of surgery before instillation of any ophthalmic solutions. The medical records of patients with positive coagulase-negative Staphylococcus(CNS) and S. aureus cultures were reviewed to determine the factors associated with fluoroquinolone resistance. Risk factors were analyzed for age, gender, topical fluoroquinolone use within 3 months and 1 year before surgery, topical antibiotic use other than fluoroquinolone, systemic antibiotic use, recent hospitalization, ocular surgery, intravitreal anti-VEGF injection, topical or systemic immunosuppression and use of eye drops containing benzalkonium chloride.


A total of 877 eyes were cultured, yielding 1125 isolates. 75 eyes (8.6%) showed no growth. Of 665 CNS and 69 S. aureus cultures, 175 isolates (23.8%) were resistant to at least one of fluoroquinlones such as ciprofloxacin, levofloxacin, gatifloxacin and moxifloxacin. In multivariable logistic regression analysis, ocular surgery(OR=8.457), recent hospitalization(OR=6.646), use of topical fluoroquinolone within 3 months before surgery(OR=4.918) were significant predictor of fluoroquinolone resistance. Intravitreal anti-VEGF injection(OR=2.976), systemic antibiotic use(OR=2.665), use of eye drops containing benzalkonium chloride(OR=2.323), use of topical fluoroquinolone within 1 year before surgery(OR=1.943), and topical antibiotic use other than fluoroquinolone(OR=1.673) were also important.


Risk factors for fluoroquinolone resistance evaluated in this study should be taken into consideration when choosing perioperative prophylaxis in ophthalmic surgery. FINANCIAL INTEREST: NONE

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