Pathogen Surveillance for Acute Infectious Conjunctivitis
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:141 |
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| Enthalten in: |
JAMA ophthalmology - 141(2023), 12 vom: 01. Dez., Seite 1140-1144 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tsui, Edmund [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 27.12.2023 Date Revised 27.12.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1001/jamaophthalmol.2023.4785 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM364089601 |
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| 520 | |a Importance: Acute infectious conjunctivitis is a common ocular condition with major public health consequences | ||
| 520 | |a Objective: To assess regional variations and microbial etiologies of acute infectious conjunctivitis to guide treatment | ||
| 520 | |a 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 | ||
| 520 | |a Main Outcomes and Measures: Pathogens were identified by unbiased RNA deep sequencing | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
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