{"title":"Risk of conjunctival colonization by cefuroxime-resistant bacteria in cataract surgery patients younger than 75 years and aged 75 or older","authors":"J.L. Urcelay-Segura , J.M. Bellón-Cano , T. Cuesta-Rodríguez , M.E. Fernández-Rubio","doi":"10.1016/j.oftale.2025.08.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and objective</h3><div>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.</div></div><div><h3>Materials and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":93886,"journal":{"name":"Archivos de la Sociedad Espanola de Oftalmologia","volume":"100 10","pages":"Pages 592-600"},"PeriodicalIF":0.0000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archivos de la Sociedad Espanola de Oftalmologia","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2173579425001501","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
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.
背景与目的:白内障术后眼内炎(PE)中分离的细菌减少为头孢呋辛耐药菌;年龄0 ~ 84岁存在革兰氏阴性菌和葡萄球菌所致PEs的风险;未发现最丰富的分离株肠球菌的风险。术前结膜中肠球菌的流行与年龄、糖尿病、肥胖和泪囊造口史(DCR-history)有关。该研究的目的是区分年龄与其他患者特征的风险,建立了两个不同的年龄组。材料和方法:我们在一家三级转诊中心进行了回顾性横断面研究。在7085例< 75岁和7798例≥75岁的患者中,计算肠球菌、肠杆菌科、非发酵革兰氏阴性杆菌(NFGNB)和凝固酶阴性葡萄球菌(CNS)的发病率比(IRR),考虑以下因素:糖尿病、肥胖、dcr病史、性别-男性、吸烟习惯和气候,采用多变量泊松回归,IBM SPSS Statistic for Windows,版本25.0。结果:糖尿病、肥胖、男性性行为和吸烟习惯在< 75岁的患者中更为普遍。该年龄组肠球菌、肠杆菌科和NFGNB的IRRs较高:[肠球菌:糖尿病,1.54 vs 1.42;肥胖,2.95比1.50;dcr -病史(3.78 vs 1.08);[肠杆菌科IRRs:糖尿病,1.47 vs 1.13;肥胖,2.27 vs 1.99;男性(1.76 vs 1.65);[NFGNB irs:糖尿病,1.79 vs 1.16;秋天的天气,2.05 vs 1.56]。糖尿病-肥胖同时发生:肠杆菌科IRR, 3.30 vs 2.28;肠球菌IRR为3.28 vs 1.62。结论:糖尿病、肥胖和有dcr病史的患者< 75岁时肠球菌、肠杆菌科和NFGNB的IRR高于≥75岁患者。