Conjunctivitis associated with methicillin-resistant Staphylococcus aureus in a long-term-care facility.

Purpose: To determine the clinical characteristics of conjunctivitis associated with methicillin-resistant Staphylococcus aureus (MRSA) in a long-term-care facility.

Patients And Methods: We followed 20 episodes of MRSA-associated conjunctivitis in 19 patients occurring over a three-year period in a 432-bed long-term-care facility.

Results: The clinical picture was that of a purulent conjunctivitis from which MRSA was isolated on culture. Seventeen patients had severe, pre-existing neurologic impairment. Nine were colonized by MRSA before the onset of conjunctivitis. Seven of eight patients treated with oral ciprofloxacin and all eight patients treated with topical vancomycin showed clinical resolution of conjunctivitis. Persistence of MRSA colonization at a variety of anatomic sites was noted after therapy following 14 episodes.

Conclusion: MRSA-associated conjunctivitis in our long-term-care facility was notable for its occurrence in patients with severe neurologic disease. Both oral ciprofloxacin and topical vancomycin therapy were associated with clinical resolution. Since MRSA is endemic in many long-term-care facilities, it is likely that MRSA-associated conjunctivitis will be increasingly recognized.