Archivos de la Sociedad Espanola de Oftalmologia · 2025
Risk of conjunctival colonization by cefuroxime-resistant bacteria in cataract surgery patients younger than 75 years and aged 75 or older.
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Urcelay-Segura J L, Bellón-Cano J M, Cuesta-Rodríguez T, Fernández-Rubio M E
Аннотация
BACKGROUND AND OBJECTIVE: Bacteria isolated in postoperative endophthalmitis (PE) were reduced to cefuroxime-resistant bacteria in cataract surgery with intracameral cefuroxime as prophylaxis; age > 84 years was at risk for PEs caused by Gram-negative-bacteria and Staphylococci; no risks were identified for Enterococci, the most abundant isolations. The prevalence of Enterococci in the preoperative conjunctiva was associated with age > 74 years, diabetes, obesity, and dacryocystorhinostomy-history (DCR-history). The aim of the study is to differentiate the risk of age from that of other patient characteristics, establishing 2 different age groups.
MATERIALS AND METHODS: We conducted a retrospective cross-sectional study in a tertiary referral center. In 7,085 patients < 75 years old and 7,798 ≥ 75 years, the incidence rate ratio (IRR) of Enterococci, Enterobacteriaceae, Non-fermentative-Gram-negative-bacilli (NFGNB) and Coagulase-negative-Staphylococci (CNS) was calculated for the following factors: diabetes, obesity, DCR-history, sex-male, smoking-habit, and climate, using multivariate Poisson regression, IBM SPSS Statistic for Windows, version 25.0. Armonk, NY: IBM Corp.
RESULTS: Diabetes, obesity, male-sex and smoking-habit were more prevalent in patients < 75 years old. The IRRs of Enterococci, Enterobacteriaceae and NFGNB were higher in this age group: [Enterococci IRRs: diabetes, 1.54 vs 1.42; obesity, 2.95 vs 1.50; DCR-history, 3.78 vs 1.08]; [Enterobacteriaceae IRRs: diabetes, 1.47 vs 1.13; obesity, 2.27 vs 1.99; male-sex, 1.76 vs 1.65]; [NFGNB IRRs: diabetes, 1.79 vs 1.16; autumn-weather, 2.05 vs 1.56]. Diabetes-obesity simultaneously: Enterobacteriaceae IRR, 3.30 vs 2.28; Enterococci IRR, 3.28 vs 1.62.
CONCLUSIONS: Diabetes, obesity and DCR-history increase the IRR of Enterococci, Enterobacteriaceae and NFGNB in patients < 75 years more than they actually do in patients ≥ 75.
MATERIALS AND METHODS: We conducted a retrospective cross-sectional study in a tertiary referral center. In 7,085 patients < 75 years old and 7,798 ≥ 75 years, the incidence rate ratio (IRR) of Enterococci, Enterobacteriaceae, Non-fermentative-Gram-negative-bacilli (NFGNB) and Coagulase-negative-Staphylococci (CNS) was calculated for the following factors: diabetes, obesity, DCR-history, sex-male, smoking-habit, and climate, using multivariate Poisson regression, IBM SPSS Statistic for Windows, version 25.0. Armonk, NY: IBM Corp.
RESULTS: Diabetes, obesity, male-sex and smoking-habit were more prevalent in patients < 75 years old. The IRRs of Enterococci, Enterobacteriaceae and NFGNB were higher in this age group: [Enterococci IRRs: diabetes, 1.54 vs 1.42; obesity, 2.95 vs 1.50; DCR-history, 3.78 vs 1.08]; [Enterobacteriaceae IRRs: diabetes, 1.47 vs 1.13; obesity, 2.27 vs 1.99; male-sex, 1.76 vs 1.65]; [NFGNB IRRs: diabetes, 1.79 vs 1.16; autumn-weather, 2.05 vs 1.56]. Diabetes-obesity simultaneously: Enterobacteriaceae IRR, 3.30 vs 2.28; Enterococci IRR, 3.28 vs 1.62.
CONCLUSIONS: Diabetes, obesity and DCR-history increase the IRR of Enterococci, Enterobacteriaceae and NFGNB in patients < 75 years more than they actually do in patients ≥ 75.