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, p...
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| Veröffentlicht in: | Archives of ophthalmology (1960) 2023-12, Vol.141 (12), p.1140-1144 |
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| creator | Tsui, Edmund Sella, Ruti Tham, Vivien Kong, Alan W McClean, Esmeralda Goren, Lee Bahar, Irit Cherian, Nina Ramirez, Joana Hughes, Reginald E Privratsky, Joseph K Onclinx, Tania Feit-Leichman, Rachel Cheng, Angel Molina, Iliana Kim, Phillip Yu, Carol Ruder, Kevin Tan, Alexander Chen, Cindi Liu, YuHeng Abraham, Thomas Hinterwirth, Armin Zhong, Lina Porco, Travis C Lietman, Thomas M Seitzman, Gerami D Doan, Thuy |
| description | 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. |
| doi_str_mv | 10.1001/jamaophthalmol.2023.4785 |
| format | Article |
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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.</description><identifier>ISSN: 2168-6165</identifier><identifier>ISSN: 2168-6173</identifier><identifier>EISSN: 2168-6173</identifier><identifier>DOI: 10.1001/jamaophthalmol.2023.4785</identifier><identifier>PMID: 37917077</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>Acute Disease ; Bacteria ; Comments ; Conjunctivitis ; Conjunctivitis - microbiology ; Coronaviruses ; Cross-Sectional Studies ; Female ; Herpes simplex ; Humans ; Middle Aged ; Online First ; Original Investigation ; Pathogens ; Public health ; Public Health Surveillance ; Ribonucleic acid ; RNA ; Severe acute respiratory syndrome coronavirus 2</subject><ispartof>Archives of ophthalmology (1960), 2023-12, Vol.141 (12), p.1140-1144</ispartof><rights>Copyright American Medical Association Dec 2023</rights><rights>Copyright 2023 American Medical Association. All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-a363t-dfd4f0a6c5e667725dad270ab7e855bb7592cf02c2ca21eef43fab5e9511be2d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jamaophthalmology/articlepdf/10.1001/jamaophthalmol.2023.4785$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2023.4785$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,230,314,776,780,881,3327,27901,27902,76232,76235</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37917077$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tsui, Edmund</creatorcontrib><creatorcontrib>Sella, Ruti</creatorcontrib><creatorcontrib>Tham, Vivien</creatorcontrib><creatorcontrib>Kong, Alan W</creatorcontrib><creatorcontrib>McClean, Esmeralda</creatorcontrib><creatorcontrib>Goren, Lee</creatorcontrib><creatorcontrib>Bahar, Irit</creatorcontrib><creatorcontrib>Cherian, Nina</creatorcontrib><creatorcontrib>Ramirez, Joana</creatorcontrib><creatorcontrib>Hughes, Reginald E</creatorcontrib><creatorcontrib>Privratsky, Joseph K</creatorcontrib><creatorcontrib>Onclinx, Tania</creatorcontrib><creatorcontrib>Feit-Leichman, Rachel</creatorcontrib><creatorcontrib>Cheng, Angel</creatorcontrib><creatorcontrib>Molina, Iliana</creatorcontrib><creatorcontrib>Kim, Phillip</creatorcontrib><creatorcontrib>Yu, Carol</creatorcontrib><creatorcontrib>Ruder, Kevin</creatorcontrib><creatorcontrib>Tan, Alexander</creatorcontrib><creatorcontrib>Chen, Cindi</creatorcontrib><creatorcontrib>Liu, YuHeng</creatorcontrib><creatorcontrib>Abraham, Thomas</creatorcontrib><creatorcontrib>Hinterwirth, Armin</creatorcontrib><creatorcontrib>Zhong, Lina</creatorcontrib><creatorcontrib>Porco, Travis C</creatorcontrib><creatorcontrib>Lietman, Thomas M</creatorcontrib><creatorcontrib>Seitzman, Gerami D</creatorcontrib><creatorcontrib>Doan, Thuy</creatorcontrib><creatorcontrib>SCORPIO Study Group</creatorcontrib><title>Pathogen Surveillance for Acute Infectious Conjunctivitis</title><title>Archives of ophthalmology (1960)</title><addtitle>JAMA Ophthalmol</addtitle><description>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.</description><subject>Acute Disease</subject><subject>Bacteria</subject><subject>Comments</subject><subject>Conjunctivitis</subject><subject>Conjunctivitis - microbiology</subject><subject>Coronaviruses</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Herpes simplex</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Online First</subject><subject>Original Investigation</subject><subject>Pathogens</subject><subject>Public health</subject><subject>Public Health Surveillance</subject><subject>Ribonucleic acid</subject><subject>RNA</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><issn>2168-6165</issn><issn>2168-6173</issn><issn>2168-6173</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkUtLAzEUhYMotqh_wIUMuHHTmsfkMSspxRcUFNR1yGRu7JSZSU1mCv57U6pFzSa53O8e7slBKCN4SjAm1yvTGr9e9kvTtL6ZUkzZNJeKH6AxJUJNBJHscP8WfITOYlzhdBTGOePHaMRkQSSWcoyKZ9Mv_Tt02csQNlA3jeksZM6HbGaHHrLHzoHtaz_EbO671dClYlP3dTxFR840Ec6-7xP0dnf7On-YLJ7uH-ezxcQwwfpJ5arcYSMsByGkpLwyFZXYlBIU52UpeUGtw9RSaygBcDlzpuRQcEJKoBU7QTc73fVQtlBZ6PpgGr0OdWvCp_am1n87Xb3U736jCRaU0aJIClffCsF_DBB73dbRwtYqJF-aqrQJU-k_Enr5D135IXTJn6YFlrniUuBEqR1lg48xgNtvQ7DeZqT_ZqS3GeltRmn04reb_eBPIgk43wFJYd-lipC0IPsCqFmbkQ</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Tsui, Edmund</creator><creator>Sella, Ruti</creator><creator>Tham, Vivien</creator><creator>Kong, Alan W</creator><creator>McClean, Esmeralda</creator><creator>Goren, Lee</creator><creator>Bahar, Irit</creator><creator>Cherian, Nina</creator><creator>Ramirez, Joana</creator><creator>Hughes, Reginald E</creator><creator>Privratsky, Joseph K</creator><creator>Onclinx, Tania</creator><creator>Feit-Leichman, Rachel</creator><creator>Cheng, Angel</creator><creator>Molina, Iliana</creator><creator>Kim, Phillip</creator><creator>Yu, Carol</creator><creator>Ruder, Kevin</creator><creator>Tan, Alexander</creator><creator>Chen, Cindi</creator><creator>Liu, YuHeng</creator><creator>Abraham, Thomas</creator><creator>Hinterwirth, Armin</creator><creator>Zhong, Lina</creator><creator>Porco, Travis C</creator><creator>Lietman, Thomas M</creator><creator>Seitzman, Gerami D</creator><creator>Doan, Thuy</creator><general>American Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20231201</creationdate><title>Pathogen Surveillance for Acute Infectious Conjunctivitis</title><author>Tsui, Edmund ; 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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.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>37917077</pmid><doi>10.1001/jamaophthalmol.2023.4785</doi><tpages>5</tpages></addata></record> |
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| subjects | Acute Disease Bacteria Comments Conjunctivitis Conjunctivitis - microbiology Coronaviruses Cross-Sectional Studies Female Herpes simplex Humans Middle Aged Online First Original Investigation Pathogens Public health Public Health Surveillance Ribonucleic acid RNA Severe acute respiratory syndrome coronavirus 2 |
| title | Pathogen Surveillance for Acute Infectious Conjunctivitis |
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