Journal Article

A Cluster of Cases of <i>Mycobacterium szulgai</i> Keratitis That Occurred after Laser-Assisted In Situ Keratomileusis

Gary P. Holmes, Gregory B. Bond, Robert C. Fader and Samuel F. Fulcher

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 8, pages 1039-1046
Published in print April 2002 | ISSN: 1058-4838
Published online April 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/339487
A Cluster of Cases of Mycobacterium szulgai Keratitis That Occurred after Laser-Assisted In Situ Keratomileusis

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Laser-assisted in situ keratomileusis (LASIK) is a recently developed ophthalmic procedure. When 2 patients developed keratitis caused by Mycobacterium szulgai after they underwent LASIK surgery, we conducted a retrospective cohort study of all LASIK procedures performed at Scott & White Clinic (Temple, Texas) during a 4.5-month period. Seven patients had compatible symptoms and signs, 5 of whom had confirmed M. szulgai keratitis. Five cases occurred among 30 procedures performed by doctor A, and there were no cases among 62 procedures performed by doctor B (approximate relative risk, 12.0; 95% confidence interval, 1.6–679.0; P = .0029). Doctor A had chilled syringes of saline solution in ice for intraoperative lavage—the only factor that differentiated the procedures of the 2 surgeons. Cultures of samples from the source ice machine's drain identified M. szulgai; the strain was identical to isolates recovered from all confirmed cases and differed from 4 standard M. szulgai strains, as determined by pulsed-field gel electrophoresis. Intraoperative contamination from ice water apparently led to M. szulgai keratitis in these patients.

Journal Article.  6129 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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