Pathogen Surveillance for Acute Infectious Conjunctivitis
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Published:2023-12-01
Issue:12
Volume:141
Page:1140
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ISSN:2168-6165
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Container-title:JAMA Ophthalmology
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language:en
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Short-container-title:JAMA Ophthalmol
Author:
Tsui Edmund12, Sella Ruti34, Tham Vivien56, Kong Alan W.2, McClean Esmeralda7, Goren Lee3, Bahar Irit34, Cherian Nina12, Ramirez Joana12, Hughes Reginald E.12, Privratsky Joseph K.12, Onclinx Tania2, Feit-Leichman Rachel2, Cheng Angel5, Molina Iliana7, Kim Phillip7, Yu Carol7, Ruder Kevin8, Tan Alexander5, Chen Cindi8, Liu YuHeng8, Abraham Thomas8, Hinterwirth Armin8, Zhong Lina8, Porco Travis C.89, Lietman Thomas M.89, Seitzman Gerami D.89, Doan Thuy89, Prajna Lalitha10, Prajna N. Venkatesh10, Gunasekaran Ramesh10, Sharma Sankalp Singh10, Teja Vishnu10, Chaudhary Meenu10, Sitaula Sanjeeta10, Sié Ali10, Coulibaly Boubacar10, Bountogo Mamadou10, Somkijrungroj Thanapong10, Satitpitakul Vannarut10, Tran Huy10, Mai Linh Hoàng10, Xuân Thảo Hạ10, Tran Yen10, Urzua Cristhian A.10, Vega Fabian10, Salgado Felipe10, Cuitino Loreto10, Pérez Fernando Pérez10, Macías Martínez Jaime10, Lansingh Van Charles10, Thanapaisal Sukhumal10, Laovirojjanakul Wipada10, McKie George10, Chavez Kenia10, Redd Travis10, Chamberlain Winston10, Sansanayudh Wiwan10, Yakoura Abba Kaka Hajia10, Amza Abdou10, Youssoufou Souley Abdoul Salam10, Nouhou Diori Adam10, Nassirou Beido10, Kadri Boubacar10, Mariama Boubacar10, Ibrahim Cissé Mamadou10, Roufaye Lamine Aboubacar10, Boulhassane Ramatou10, Ali Saley10, Abdou Zakou10, Kelliher Clare10, Green Laura10, Ong Hon Shing10, Mehta Jod10, Liu Yu-Chi10, Hwang De-Kuang10, Fan Nai-Wen10, Chiong Hong Sheng10, Lacorzana Javier10, Cabrera-Aguas Maria10, Watson Stephanie10, Lebas Elodie10, Colby Emily10, McLeod Stephen10, Kanai Kuniyoshi10, Whiteside Meredith10, Yeh Steven10, Fashina Tolulope10, Chodosh James10, Tarkap Bridgit10, Garap Jambi N.10, Mangot Magdalene10, Amel Edwin10, Taleo Fasihah10, Kasso Johnson10, Willie Kalbule10, Nanu Madopule10, Rymill Prudence10, Solomon Anthony W.10,
Affiliation:
1. Ocular Inflammatory Disease Center, UCLA Stein Eye Institute, Los Angeles, California 2. Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California 3. Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel 4. Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 5. Pacific Vision Institute of Hawaii, Honolulu, Hawaii 6. Department of Ophthalmology, University of Hawaii John A. Burns School of Medicine, Honolulu 7. Shiley Eye Institute, University of California, San Diego, San Diego 8. F.I. Proctor Foundation, University of California, San Francisco, San Francisco 9. Department of Ophthalmology, University of California, San Francisco, San Francisco 10. for the SCORPIO Study Group
Abstract
ImportanceAcute infectious conjunctivitis is a common ocular condition with major public health consequences.ObjectiveTo assess regional variations and microbial etiologies of acute infectious conjunctivitis to guide treatment.Design, Setting, and ParticipantsIn 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 MeasuresPathogens were identified by unbiased RNA deep sequencing.ResultsIn 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 RelevanceIn 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.
Publisher
American Medical Association (AMA)
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