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Medicine Feb 2020Acute conjunctivitis is inflammation of conjunctiva of less than 3 to 4 weeks duration, characterized by cellular infiltration and exudation. It may also result into...
Bacteriological pattern and their correlation with complications in culture positive cases of acute bacterial conjunctivitis in a tertiary care hospital of upper Assam: A cross sectional study.
Acute conjunctivitis is inflammation of conjunctiva of less than 3 to 4 weeks duration, characterized by cellular infiltration and exudation. It may also result into corneal, lid or orbital involvement which may lead to various complications.A hospital based prospective study was conducted in Assam Medical College and Hospital with 110 culture proven acute bacterial conjunctivitis cases. Primary objective was to evaluate the bacteriological pattern and secondary objectives were to evaluate seasonal variation, association of different organisms with various complications and antibiotic sensitivity pattern of the isolates.Maximum frequency of bacterial conjunctivitis observed from May to September. SA was the predominant organism isolated throughout the year (32.1%). Commonest single organism isolates were SE (26.1%) and SA (21.6%). True membrane formation was significantly associated with CD (P < .05), whereas pseudo-membrane formation was associated with SA and STBH isolation (P < .05). Isolation of SE, SA, and PA was associated with corneal involvement (P < .05). Lid involvement was seen with SA and Diphtheroid, whereas SP isolation was associated with concomitant dacryocystitis (P < .05). All the major organisms were (SE, SA, D, STBH, SP) highly sensitive to amino-glycosides, cephalosporins, chloromphenicol, vancomycin and linezolid, whereas high level of resistance was seen towards fluroquinolones (ciprofloxacin and moxifloxacin).All acute bacterial conjunctivitis cases don't require antibiotic therapy. In case if required, periodical culture and sensitivity may guide initial pre-emptive antibiotic therapy. Further choice of antibiotic should be govern by culture and sensitivity status.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacteria; Child; Child, Preschool; Conjunctivitis, Bacterial; Cross-Sectional Studies; Drug Resistance, Bacterial; Female; Humans; Infant; Male; Microbial Sensitivity Tests; Middle Aged; Prospective Studies; Tertiary Care Centers; Young Adult
PubMed: 32049777
DOI: 10.1097/MD.0000000000018570 -
PeerJ 2022Bacterial communities in and on wild hosts are increasingly appreciated for their importance in host health. Through both direct and indirect interactions, bacteria...
Bacterial communities in and on wild hosts are increasingly appreciated for their importance in host health. Through both direct and indirect interactions, bacteria lining vertebrate gut mucosa provide hosts protection against infectious pathogens, sometimes even in distal body regions through immune regulation. In house finches (), the bacterial pathogen (MG) causes conjunctivitis, with ocular inflammation mediated by pro- and anti-inflammatory cytokines and infection triggering MG-specific antibodies. Here, we tested the role of gut bacteria in host responses to MG by using oral antibiotics to perturb bacteria in the gut of captive house finches prior to experimental inoculation with MG. We found no clear support for an impact of gut bacterial disruption on conjunctival pathology, MG load, or plasma antibody levels. However, there was a non-significant trend for birds with intact gut communities to have greater conjunctival pathology, suggesting a possible impact of gut bacteria on pro-inflammatory cytokine stimulation. Using 16S bacterial rRNA amplicon sequencing, we found dramatic differences in cloacal bacterial community composition between captive, wild-caught house finches in our experiment and free-living finches from the same population, with lower bacterial richness and core communities composed of fewer genera in captive finches. We hypothesize that captivity may have affected the strength of results in this experiment, necessitating further study with this consideration. The abundance of anthropogenic impacts on wildlife and their bacterial communities, alongside the emergence and spread of infectious diseases, highlights the importance of studies addressing the role of commensal bacteria in health and disease, and the consequences of gut bacterial shifts on wild hosts.
Topics: Animals; Conjunctivitis, Bacterial; Mycoplasma Infections; Finches; Conjunctiva; Mycoplasma gallisepticum; Antibodies, Bacterial
PubMed: 35707121
DOI: 10.7717/peerj.13559 -
PloS One 2020To date, studies examining polymicrobial infections in ocular disease have mostly been limited to keratitis or endophthalmitis. We characterized polybacterial infections... (Comparative Study)
Comparative Study Randomized Controlled Trial
Characterization of baseline polybacterial versus monobacterial infections in three randomized controlled bacterial conjunctivitis trials and microbial outcomes with besifloxacin ophthalmic suspension 0.6.
BACKGROUND/PURPOSE
To date, studies examining polymicrobial infections in ocular disease have mostly been limited to keratitis or endophthalmitis. We characterized polybacterial infections compared to monobacterial infections in prior clinical studies evaluating besifloxacin ophthalmic suspension 0.6% for the treatment of bacterial conjunctivitis and report on associated microbiological outcomes.
METHODS
In this post-hoc analysis, microbiological data for subjects with conjunctivitis due to one or more than one bacterial species in three previous studies (two vehicle-, one active-controlled) of besifloxacin were extracted. Bacterial species identified at baseline were deemed causative if their colony count equaled or exceeded species-specific prespecified threshold criteria. In subjects with polybacterial infections, the fold-increase over threshold was used to rank order the contribution of individual species. Baseline pathogens and their minimum inhibitory concentrations (MICs) for common ophthalmic antibiotics were compared by infection type, as were microbial eradication rates following treatment with besifloxacin.
RESULTS
Of 1041 subjects with culture-confirmed conjunctivitis, 17% had polybacterial and 83% had monobacterial conjunctivitis at baseline. In polybacterial compared to monobacterial infections, Haemophilus influenzae and Streptococcus pneumoniae were identified less frequently as the dominant infecting species (P = 0.042 and P<0.001, respectively), whereas Streptococcus mitis/S. mitis group was identified more frequently as dominant (P<0.001). Viral coinfection was also identified more frequently in polybacterial infections (P<0.001). Staphylococcus aureus was the most common coinfecting species in polybacterial infections and the second most common dominant species in such infections. With few exceptions, MICs for individual species were comparable regardless of infection type. Clinical microbial eradication rates with besifloxacin were high regardless of infection type (P≤0.016 vs vehicle at follow-up visits).
CONCLUSIONS
Approximately one in five subjects with bacterial conjunctivitis are infected with more than one bacterial species underscoring the need for a broad-spectrum antibiotic for such infections. Besifloxacin treatment resulted in robust eradication rates of these infections comparable to monobacterial infections.
TRIAL REGISTRATION
NCT000622908, NCT00347932, NCT00348348.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Azepines; Bacteria; Child; Child, Preschool; Conjunctivitis, Bacterial; Double-Blind Method; Female; Fluoroquinolones; Follow-Up Studies; Humans; Infant; Infant, Newborn; Male; Microbial Sensitivity Tests; Middle Aged; Prognosis; Prospective Studies; Young Adult
PubMed: 32841261
DOI: 10.1371/journal.pone.0237603 -
PLoS Neglected Tropical Diseases Dec 2015
Review
Topics: Anti-Bacterial Agents; Azithromycin; Global Health; Humans; Trachoma; Yaws
PubMed: 26633176
DOI: 10.1371/journal.pntd.0004071 -
Archives of Disease in Childhood Jun 1986Maternal chlamydial antibodies were determined in cord sera of 41 infants who developed neonatal chlamydial conjunctivitis and compared with the antibody profile of...
Maternal chlamydial antibodies were determined in cord sera of 41 infants who developed neonatal chlamydial conjunctivitis and compared with the antibody profile of infants who had been exposed to Chlamydia trachomatis at birth by their isolation positive mothers but in whom conjunctivitis did not develop. No protective effect could be attributed to maternal antibodies transferred to the infants. Paired sera samples were collected from 18 infants with chlamydial conjunctivitis. Chlamydial IgM antibodies were detected in four of these 18 cases at the time diagnosis was established by isolation. An additional eight cases had developed chlamydial IgM at the time the convalescent sera samples were taken, on average on day 40. At that time symptoms had disappeared after systemic treatment had been given. Thus chlamydial IgM antibodies were eventually shown in two thirds of infants with chlamydial conjunctivitis who were all systemically treated and clinically healed. These data suggest a cautious assessment of chlamydial IgM in the diagnosis of chlamydial pneumonia.
Topics: Adult; Antibodies, Bacterial; Chlamydia trachomatis; Chlamydiaceae Infections; Conjunctivitis, Inclusion; Female; Fetal Blood; Genital Diseases, Female; Humans; Immunity, Maternally-Acquired; Immunoglobulin G; Immunoglobulin M; Infant, Newborn
PubMed: 3729525
DOI: 10.1136/adc.61.6.565 -
Clinical Microbiology and Infection :... Dec 2003Neisseria meningitidis is an uncommon cause of acute bacterial conjunctivitis. One case of primary meningococcal conjunctivitis in a healthy 6-year-old boy is reported....
Neisseria meningitidis is an uncommon cause of acute bacterial conjunctivitis. One case of primary meningococcal conjunctivitis in a healthy 6-year-old boy is reported. The patient was initially treated with a topical instillation of polymyxin B, neomycin and gramicidin in ophthalmic solution, and this was followed by systemic rifampin once the diagnosis had been established. No ocular or systemic complications developed.
Topics: Administration, Oral; Administration, Topical; Anti-Bacterial Agents; Child; Conjunctivitis, Bacterial; Gramicidin; Humans; Male; Meningococcal Infections; Neisseria meningitidis; Neomycin; Polymyxin B; Rifampin
PubMed: 14686993
DOI: 10.1111/j.1469-0691.2003.00799.x -
Investigative Ophthalmology & Visual... May 2018Bacterial conjunctivitis is a major problem in ocular health. Little is known about protective immune effectors in the conjunctiva. We evaluated whether opsonic antibody...
PURPOSE
Bacterial conjunctivitis is a major problem in ocular health. Little is known about protective immune effectors in the conjunctiva. We evaluated whether opsonic antibody to the conserved surface/capsular polysaccharide poly-N-acetyl glucosamine (PNAG) expressed by Streptococcus pneumoniae and Staphylococcus aureus was protective against bacterial conjunctivitis, as well as an antibody to the Pseudomonas aeruginosa surface polysaccharide alginate.
METHODS
Bacteria were injected directly into the conjunctivae of either A/J mice or into conjunctivae of wild type C57Bl/6 mice for comparisons to responses of recombination activating gene 1-knock out (RAG 1 KO) or germ-free mice in the C57Bl/6 genetic background. Human IgG1 monoclonal antibodies (MAb) to either PNAG or alginate were administered as follows: direct injection of 10 μg into the conjunctivae or topical application onto the cornea 4, 24, and 32 hours post infection; or intraperitoneal injection of 200 μg 18 hours prior to and then 4, 24, and 32-hours postinfection. After 48 hours, eyes were scored for pathology, mice were euthanized, and CFU/conjunctiva was determined.
RESULTS
All methods of antibody administration reduced S. pneumoniae, S. aureus, or P. aeruginosa pathology and bacterial levels in the conjunctivae. Histopathologic analysis showed severe inflammatory cell infiltrates in conjunctivae of mice treated with control MAb, whereas immune mice showed only very mild cellular infiltration. The protective effect of MAb to PNAG was abolished in RAG 1 KO and germ-free mice.
CONCLUSIONS
Antibodies to both PNAG and alginate demonstrated therapeutic efficacy in models of S. pneumoniae, S. aureus, and P. aeruginosa conjunctivitis, validating the protective capacity of antibodies to surface polysaccharides in distinct ocular tissues.
Topics: Acetylglucosamine; Animals; Antibodies, Monoclonal; Bacterial Capsules; Conjunctivitis, Bacterial; Disease Models, Animal; Eye Infections, Bacterial; Female; Immunoglobulin G; Injections, Intraperitoneal; Mice; Mice, Inbred A; Mice, Inbred C57BL; Pneumococcal Infections; Polysaccharides, Bacterial; Staphylococcal Infections; Staphylococcus aureus; Streptococcus pneumoniae
PubMed: 29847658
DOI: 10.1167/iovs.18-23795 -
Tidsskrift For Den Norske Laegeforening... Jun 2004Acute infectious conjunctivitis is the eye disease most commonly seen by general practitioners, and is estimated to represent 2-3% of their total number of... (Review)
Review
Acute infectious conjunctivitis is the eye disease most commonly seen by general practitioners, and is estimated to represent 2-3% of their total number of consultations. The present paper gives a review of the epidemiology, etiology, clinical picture, complications, differential diagnoses and therapy of acute bacterial conjunctivitis. The condition has an excellent prognosis with a high frequency of spontaneous remission. However, topical antibacterial therapy should always be instituted, because this will shorten the course of the disease and reduce the risk of epidemic outbreaks, particularly in institutions for children.
Topics: Acute Disease; Anti-Infective Agents, Local; Conjunctivitis, Bacterial; Diagnosis, Differential; Humans; Prognosis; Remission, Spontaneous
PubMed: 15195156
DOI: No ID Found -
The Cochrane Database of Systematic... Aug 2013Measles is the leading killer among vaccine-preventable diseases; it is responsible for an estimated 44% of the 1.7 million vaccine-preventable deaths among children... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Measles is the leading killer among vaccine-preventable diseases; it is responsible for an estimated 44% of the 1.7 million vaccine-preventable deaths among children annually.
OBJECTIVES
To assess the effects of antibiotics given to children with measles to prevent complications and reduce pneumonia, other morbidities and mortality.
SEARCH METHODS
We searched CENTRAL 2013, Issue 4, MEDLINE (1966 to May week 4, 2013) and EMBASE (1980 to May 2013).
SELECTION CRITERIA
Randomised controlled trials (RCTs) and quasi-RCTs comparing antibiotics with placebo or no treatment, to prevent complications in children with measles.
DATA COLLECTION AND ANALYSIS
Two review authors independently extracted data and assessed trial quality.
MAIN RESULTS
Seven trials with 1263 children were included. The methodological quality of most studies was poor. Only two studies were randomized, double-blind trials. There was variation in antibiotics used, their doses, schedule and evaluation of outcome. Pooled study data showed that the incidence of pneumonia was lower in the treatment group compared to the control group. However, the difference was not statistically significant. Of the 654 children who received antibiotics, 27 (4.1%) developed pneumonia; while out of 609 children in the control group, 59 (9.6%) developed pneumonia (odds ratio (OR) 0.35; 95% confidence interval (0.12 to 1.01). The one trial that showed an increase in the rate of pneumonia with antibiotics was conducted in 1942 and compared oral sulfathiazole with symptomatic treatment. If the results of this trial are removed from the meta-analysis, there is a statistically significant reduction in the incidence of pneumonia in children receiving antibiotics (OR 0.26; 95% CI 0.12 to 0.60). The incidence of other complications was significantly lower in children receiving antibiotics: purulent otitis media (OR 0.34; 95% CI 0.16 to 0.73) and tonsillitis (OR 0.08; 95% CI 0.01 to 0.72). There was no difference in the incidence of conjunctivitis (OR 0.39; 95% CI 0.15 to 1.0), diarrhea (OR 0.53; 95% CI 0.23 to 1.22) or croup (OR 0.16; 95% CI 0.01 to 4.06). No major adverse effects attributable to antibiotics were reported.
AUTHORS' CONCLUSIONS
The studies reviewed were of poor quality and used older antibiotics. This review suggests a beneficial effect of antibiotics in preventing complications such as pneumonia, purulent otitis media and tonsillitis in children with measles. On the basis of this review, it is not possible to recommend definitive guidelines on the type of antibiotic, duration or the day of initiation. There is a need for more evidence from high-quality RCTs to answer these questions.
Topics: Anti-Bacterial Agents; Child; Conjunctivitis, Bacterial; Croup; Diarrhea; Humans; Measles; Otitis Media; Pneumonia; Randomized Controlled Trials as Topic; Tonsillitis
PubMed: 23943263
DOI: 10.1002/14651858.CD001477.pub4 -
Eye (London, England) Jul 2015To report the prevalence of gonococcal conjunctivitis (GC) presenting to a tertiary referral maternity hospital (NMH) and a tertiary referral ophthalmic hospital (RVEEH)...
PURPOSE
To report the prevalence of gonococcal conjunctivitis (GC) presenting to a tertiary referral maternity hospital (NMH) and a tertiary referral ophthalmic hospital (RVEEH) from 2011 to 2013 and describe the demographics, clinical presentation, and antibiotic susceptibility of Neisseria gonorrhoeae ocular infections.
METHODS
Demographic, clinical, and microbiological data were collected from patients with laboratory confirmed GC.
RESULTS
There were 27 556 live births at NMH during the study period, and no case of neonatal GC was identified. Fourteen cases of GC were identified at RVEEH in this period, representing a prevalence of 0.19 cases per 1000 eye emergency attendees. Antibiotic susceptibility data were available on nine cases, of which, all were ceftriaxone- and ciprofloxacin sensitive. 64.3% of patients were male, with a mean age of 18 years. The mean duration of symptoms was 3 days. All patients presented with unilateral conjunctival injection and purulent discharge. Eight cases had visual impairment at presentation and their mean visual acuity was 6/15. Corneal involvement was present in 25% of patients. Uveitis was not detected. On receipt of positive culture and/or PCR results, treatment was altered in two thirds of patients. All patients were referred for full STI screening and all patients showed a full clinical recovery 1 week posttreatment.
CONCLUSION
We observed that GC presented in young adults with a male predominance and was rare in neonates. In cases of unilateral purulent conjunctivitis, there should be a high clinical suspicion of GC, early swab for PCR and culture, and knowledge of current CDC-recommended antibiotic guidelines.
Topics: Adolescent; Anti-Bacterial Agents; Ceftriaxone; Child; Child, Preschool; Ciprofloxacin; Conjunctivitis, Bacterial; Eye Infections, Bacterial; Female; Gonorrhea; Hospitals, Maternity; Hospitals, Special; Humans; Ireland; Male; Microbial Sensitivity Tests; Neisseria gonorrhoeae; Ophthalmia Neonatorum; Ophthalmology; Polymerase Chain Reaction; Prevalence; Young Adult
PubMed: 25907207
DOI: 10.1038/eye.2015.57