Pathogen Surveillance for Acute Infectious Conjunctivitis.

Autor:	Tsui E; Ocular Inflammatory Disease Center, UCLA Stein Eye Institute, Los Angeles, California.; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California., Sella R; Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Tham V; Pacific Vision Institute of Hawaii, Honolulu, Hawaii.; Department of Ophthalmology, University of Hawaii John A. Burns School of Medicine, Honolulu., Kong AW; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California., McClean E; Shiley Eye Institute, University of California, San Diego, San Diego., Goren L; Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel., Bahar I; Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Cherian N; Ocular Inflammatory Disease Center, UCLA Stein Eye Institute, Los Angeles, California.; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California., Ramirez J; Ocular Inflammatory Disease Center, UCLA Stein Eye Institute, Los Angeles, California.; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California., Hughes RE Jr; Ocular Inflammatory Disease Center, UCLA Stein Eye Institute, Los Angeles, California.; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California., Privratsky JK; Ocular Inflammatory Disease Center, UCLA Stein Eye Institute, Los Angeles, California.; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California., Onclinx T; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California., Feit-Leichman R; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California., Cheng A; Pacific Vision Institute of Hawaii, Honolulu, Hawaii., Molina I; Shiley Eye Institute, University of California, San Diego, San Diego., Kim P; Shiley Eye Institute, University of California, San Diego, San Diego., Yu C; Shiley Eye Institute, University of California, San Diego, San Diego., Ruder K; F.I. Proctor Foundation, University of California, San Francisco, San Francisco., Tan A; Pacific Vision Institute of Hawaii, Honolulu, Hawaii., Chen C; F.I. Proctor Foundation, University of California, San Francisco, San Francisco., Liu Y; F.I. Proctor Foundation, University of California, San Francisco, San Francisco., Abraham T; F.I. Proctor Foundation, University of California, San Francisco, San Francisco., Hinterwirth A; F.I. Proctor Foundation, University of California, San Francisco, San Francisco., Zhong L; F.I. Proctor Foundation, University of California, San Francisco, San Francisco., Porco TC; F.I. Proctor Foundation, University of California, San Francisco, San Francisco.; Department of Ophthalmology, University of California, San Francisco, San Francisco., Lietman TM; F.I. Proctor Foundation, University of California, San Francisco, San Francisco.; Department of Ophthalmology, University of California, San Francisco, San Francisco., Seitzman GD; F.I. Proctor Foundation, University of California, San Francisco, San Francisco.; Department of Ophthalmology, University of California, San Francisco, San Francisco., Doan T; F.I. Proctor Foundation, University of California, San Francisco, San Francisco.; Department of Ophthalmology, University of California, San Francisco, San Francisco.
Jazyk:	angličtina
Zdroj:	JAMA ophthalmology [JAMA Ophthalmol] 2023 Dec 01; Vol. 141 (12), pp. 1140-1144.
DOI:	10.1001/jamaophthalmol.2023.4785
Abstrakt:	Importance: Acute infectious conjunctivitis is a common ocular condition with major public health consequences. Objective: To assess regional variations and microbial etiologies of acute infectious conjunctivitis to guide treatment. Design, Setting, and Participants: In this cross-sectional study, patients with presumed acute infectious conjunctivitis were enrolled in the study at 5 sites (Honolulu, Hawaii; Los Angeles, San Francisco, and San Diego, California; and Petah-Tikva, Israel) from March 2021 to March 2023. Patients with allergic or toxic conjunctivitis were excluded. Main Outcomes and Measures: Pathogens were identified by unbiased RNA deep sequencing. Results: In all, 52 patients (mean [range] age, 48 [7-80] years; 31 females [60%]) were enrolled at 5 sites (6 patients from Honolulu, 9 from San Diego, 11 from Los Angeles, 13 from San Francisco, and 13 from Petah-Tikva). RNA deep sequencing detected human adenovirus species D in one-quarter of patients (13 of 52). A wide range of pathogens, including human coronavirus 229E, SARS-CoV-2, and herpes simplex virus type 1, was also identified, as well as several bacteria and fungi. Moreover, 62% (32 of 52) of patients presented with purulent discharge, while only 8% (4 of 52) of patients had confirmed bacterial pathogens. Conclusion and Relevance: In this cross-sectional study, pathogens associated with acute infectious conjunctivitis varied between all 5 sites in the US and Israel. Purulent discharge was a common presenting sign in this study, with a low specificity for bacteria-associated conjunctivitis, suggesting that further diagnostic workup may be necessary to inform antibiotic stewardship. Additional research on cost-effectiveness of using RNA deep sequencing is needed to ascertain whether it is better to monitor patients clinically until resolution of disease.
Databáze:	MEDLINE
Externí odkaz: