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Clinical Ophthalmology (Auckland, N.Z.) 2024Millions of acute conjunctivitis cases occur in the United States annually. The impact of COVID-19 mitigation practices on viral conjunctivitis incidence within...
BACKGROUND
Millions of acute conjunctivitis cases occur in the United States annually. The impact of COVID-19 mitigation practices on viral conjunctivitis incidence within ophthalmology clinics has not been reported. We hypothesized that viral conjunctivitis rates would decrease with implementation of such practices.
METHODS
A retrospective chart review was conducted at a single academic center's ophthalmology clinics. Electronic health record data was queried using ICD-10 diagnostic codes to include 649 patients aged 2-97 with viral, bacterial, or allergic conjunctivitis diagnosed either before (6/1/2018-5/1/2019) or during (6/1/2020-5/1/2021) COVID-19 precautions. Conjunctivitis rates per ophthalmology clinic visit were compared using rate-ratio analysis. Logistic regression evaluated the effects of age, sex, and race among those with conjunctivitis.
RESULTS
A total of 66,027 ophthalmology clinic visits occurred during the study period. Viral conjunctivitis rates per visit did not significantly change after enacting COVID-19 mitigation strategies, but allergic conjunctivitis rates significantly increased (viral: RR 0.82, 95% CI 0.51 to 1.31, p=0.408; allergic: RR 1.70, 95% CI 1.43 to 2.03, p<0.001). When controlling for time, younger age (≤ median age 55) (p=0.005) and Caucasian race (p=0.009) were associated with higher viral conjunctivitis frequency.
CONCLUSION
Contrary to trends reported in emergency departments, viral conjunctivitis rates within an ophthalmology clinic did not significantly change after COVID-19 mitigation strategies, though allergic conjunctivitis rates increased. Patients' avoidance of emergency departments during the pandemic may have contributed. Further investigation is required to explore variation in ophthalmology patient populations and needs based on care setting.
PubMed: 38746646
DOI: 10.2147/OPTH.S445315 -
PLoS Neglected Tropical Diseases Apr 2024Trachoma is the leading infectious cause of blindness worldwide and is now largely confined to around 40 low- and middle-income countries. It is caused by Chlamydia...
Trachoma is the leading infectious cause of blindness worldwide and is now largely confined to around 40 low- and middle-income countries. It is caused by Chlamydia trachomatis (Ct), a contagious intracellular bacterium. The World Health Organization recommends mass drug administration (MDA) with azithromycin for treatment and control of ocular Ct infections, alongside improving facial cleanliness and environmental conditions to reduce transmission. To understand the molecular epidemiology of trachoma, especially in the context of MDA and transmission dynamics, the identification of Ct genotypes could be useful. While many studies have used the Ct major outer membrane protein gene (ompA) for genotyping, it has limitations. Our study applies a typing system novel to trachoma, Multiple Loci Variable Number Tandem Repeat Analysis combined with ompA (MLVA-ompA). Ocular swabs were collected post-MDA from four trachoma-endemic zones in Ethiopia between 2011-2017. DNA from 300 children with high Ct polymerase chain reaction (PCR) loads was typed using MLVA-ompA, utilizing 3 variable number tandem repeat (VNTR) loci within the Ct genome. Results show that MLVA-ompA exhibited high discriminatory power (0.981) surpassing the recommended threshold for epidemiological studies. We identified 87 MLVA-ompA variants across 26 districts. No significant associations were found between variants and clinical signs or chlamydial load. Notably, overall Ct diversity significantly decreased after additional MDA rounds, with a higher proportion of serovar A post-MDA. Despite challenges in sequencing one VNTR locus (CT1299), MLVA-ompA demonstrated cost-effectiveness and efficiency relative to whole genome sequencing, providing valuable information for trachoma control programs on local epidemiology. The findings suggest the potential of MLVA-ompA as a reliable tool for typing ocular Ct and understanding transmission dynamics, aiding in the development of targeted interventions for trachoma control.
Topics: Chlamydia trachomatis; Trachoma; Humans; Ethiopia; Minisatellite Repeats; Bacterial Outer Membrane Proteins; Female; Male; Child, Preschool; Genotype; Molecular Typing; Azithromycin; Genetic Variation; Infant; Child; Anti-Bacterial Agents; DNA, Bacterial
PubMed: 38662795
DOI: 10.1371/journal.pntd.0012143 -
Clinical Infectious Diseases : An... Apr 2024Assessing the feasibility of 2030 as a target date for global elimination of trachoma, and identification of districts that may require enhanced treatment to meet World...
Assessing the feasibility of 2030 as a target date for global elimination of trachoma, and identification of districts that may require enhanced treatment to meet World Health Organization (WHO) elimination criteria by this date are key challenges in operational planning for trachoma programmes. Here we address these challenges by prospectively evaluating forecasting models of trachomatous inflammation-follicular (TF) prevalence, leveraging ensemble-based approaches. Seven candidate probabilistic models were developed to forecast district-wise TF prevalence in 11 760 districts, trained using district-level data on the population prevalence of TF in children aged 1-9 years from 2004 to 2022. Geographical location, history of mass drug administration treatment, and previously measured prevalence data were included in these models as key predictors. The best-performing models were included in an ensemble, using weights derived from their relative likelihood scores. To incorporate the inherent stochasticity of disease transmission and challenges of population-level surveillance, we forecasted probability distributions for the TF prevalence in each geographic district, rather than predicting a single value. Based on our probabilistic forecasts, 1.46% (95% confidence interval [CI]: 1.43-1.48%) of all districts in trachoma-endemic countries, equivalent to 172 districts, will exceed the 5% TF control threshold in 2030 with the current interventions. Global elimination of trachoma as a public health problem by 2030 may require enhanced intervention and/or surveillance of high-risk districts.
Topics: Trachoma; Humans; Child, Preschool; Infant; Child; Disease Eradication; Prevalence; Forecasting; Public Health; Models, Statistical; Mass Drug Administration; World Health Organization; Global Health; Male; Female
PubMed: 38662700
DOI: 10.1093/cid/ciae031 -
PLoS Neglected Tropical Diseases Apr 2024The Alliance for the Global Elimination of Trachoma (GET) endorses the full SAFE strategy to eliminate trachoma; Surgery (for trichiasis), Antibiotics (to reduce the... (Comparative Study)
Comparative Study
BACKGROUND
The Alliance for the Global Elimination of Trachoma (GET) endorses the full SAFE strategy to eliminate trachoma; Surgery (for trichiasis), Antibiotics (to reduce the community pool of infection, Facial cleanliness, and Environmental improvement (to decrease transmission). There is no accepted measure of facial cleanliness. This study compared two possible metrics for facial cleanliness.
METHOD/FINDINGS
Metric one: Clean face was defined as observed absence of ocular and nasal discharge on the face. Metric two: observing a grade of dirtiness (scale 10 = lightest to 0 = darkest) on a standard facial wipe. The reliability of grading a child's face or grading a facial wipe was determined in children in Kongwa Tanzania. We also observed both measurements in a cohort of 202 children ages 1 to <7years prior to face cleaning, immediately afterwards, and 4 hours afterwards. Fifty of the children did not have face cleaning and were controls. Intra-and interobserver reliability was similar for both measures, the latter = 0.53 for observing a clean face and 0.52 for grading a facial wipe. There was no correlation between the two. Both measures detected facial cleaning, compared to control children who were not cleaned, immediately after cleaning; control children with 53% clean faces and wipe score of 6.7 compared to cleaned children with 88% clean faces and wipe score of 8 (p = .0001, p = < .0001, respectively). Both measures also detected face washing 4 hours previously compared to controls.
CONCLUSIONS
The two metrics were equally reliable, and both measured the behavior of face washing. They measure different aspects of a clean face; one measures the amount of dirt on wiped area and the other measures ocular and nasal discharge. Both measurements appear to capture the behavior of facial cleaning, and the choice of metric would appear to rest on the measurement that captures the stated objective of the behavior, consideration of costs, training, logistics, and implementation.
Topics: Humans; Trachoma; Child, Preschool; Face; Tanzania; Infant; Female; Male; Child; Hygiene; Reproducibility of Results
PubMed: 38598562
DOI: 10.1371/journal.pntd.0012090 -
Minerva Medica Apr 2024
Topics: Humans; Smartphone; Acute Disease; Reproducibility of Results; Photography; Conjunctivitis, Bacterial; Patient-Centered Care; Male; Female; Adult; Middle Aged
PubMed: 38563607
DOI: 10.23736/S0026-4806.24.09252-8 -
Indian Journal of Ophthalmology Apr 2024
Topics: Humans; India; Keratitis; Conjunctivitis; Adrenal Cortex Hormones; Anti-Bacterial Agents
PubMed: 38546479
DOI: 10.4103/IJO.IJO_2448_23 -
Indian Journal of Medical Microbiology 2024Neisseria sicca, a Gram-negative diplococcus commonly found in the nasopharynx as part of normal bacterial flora, is typically non-pathogenic but has been associated... (Review)
Review
Neisseria sicca, a Gram-negative diplococcus commonly found in the nasopharynx as part of normal bacterial flora, is typically non-pathogenic but has been associated with various diseases including endocarditis, conjunctivitis, pneumonia and meningitis (Jeurissen et al., 2006; Kozlova et al., 2020; Alcid, 1980; Carter et al., 2007). In this report, we present a case of peritonitis in a patient undergoing peritoneal dialysis caused by N. sicca and review the literature on Neisseria-associated peritonitis.
Topics: Humans; Peritonitis; Peritoneal Dialysis; Anti-Bacterial Agents; Neisseria sicca; Neisseriaceae Infections; Male; Middle Aged; Female
PubMed: 38522747
DOI: 10.1016/j.ijmmb.2024.100566 -
Current Therapeutic Research, Clinical... 2024Moxifloxacin is a bactericidal methoxyquinolone used for the treatment of conjunctivitis and prophylactic therapy in cataract and refractive surgeries. Chloramphenicol...
BACKGROUND
Moxifloxacin is a bactericidal methoxyquinolone used for the treatment of conjunctivitis and prophylactic therapy in cataract and refractive surgeries. Chloramphenicol is a bacteriostatic organochlorine introduced into clinical practice in 1948 and used mainly in topical preparations because of its known toxicity.
OBJECTIVES
The study aimed to evaluate the in vitro antibacterial effect and the ocular cytotoxicity of these broad-spectrum antibiotics.
METHODS
Antimicrobic activity was tested on 4 bacteria strains ( and ), and determined through calculation of MIC and half inhibitory concentration for each microorganism. Antibacterial activity was determined by microdilution method after 24 hours' incubation with 2-fold serial dilutions (2.5 mg/mL to 4.883 µg/mL) of moxifloxacin and chloramphenicol. Disk diffusion test were performed according to European Committee on Antimicrobial Susceptibility Testing methodology. Biofilm formation inhibition and biofilm eradication concentration assay were conducted for and using the microdilution method. Cytotoxicity of antibiotics was evaluated by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) colorimetric assay on human corneal cell.
RESULTS
Cytotoxicity of antibiotics was evaluated on human epithelial corneal cells after 4 hours treatment by viability assay. Results showed that corneal cell viability was significantly higher after moxifloxacin treatment compared with chloramphenicol ( < 0.01). Moxifloxacin is characterized by a significantly lower MIC and half inhibitory concentration values and a larger inhibition zone for all the strain tested, with high performance in controlling gram-negative growth, compared with chloramphenicol. Moreover, moxifloxacin showed higher activity compared with chloramphenicol in the inhibition of biofilm formation and in the disruption of biofilm, especially against biofilm.
CONCLUSIONS
The lower corneal cell toxicity and the broader spectrum of antibacterial activity observed with moxifloxacin suggests its use in ophthalmic solution for the treatment of bacterial eye infections.
PubMed: 38511104
DOI: 10.1016/j.curtheres.2024.100740 -
The American Journal of Tropical... May 2024Millions of doses of azithromycin are distributed each year for trachoma, yet the treatment efficacy of a single dose of azithromycin for ocular Chlamydia infection has...
Millions of doses of azithromycin are distributed each year for trachoma, yet the treatment efficacy of a single dose of azithromycin for ocular Chlamydia infection has not been well characterized. In this study, four villages in Niger received a mass azithromycin distribution for trachoma. All 426 children aged 0-5 years residing in the study villages were offered conjunctival swabbing every 6 months to test for ocular Chlamydia trachomatis. Among the children infected with ocular Chlamydia before treatment, 6% (95% CI: 2-15%) tested positive for ocular Chlamydia infection 6 months later, and 15% (95% CI: 7-28%) tested positive 12 months later. The most important predictor of post-treatment ocular Chlamydia infection was pretreatment ocular Chlamydia infection (relative risk: 3.5, 95% CI: 1.3-9.4). Although the 6-monthly monitoring schedule was suboptimal for testing the treatment efficacy of an antibiotic, these findings are nonetheless consistent with high treatment efficacy of a single dose of azithromycin and suggest that additional interventions might be most effective if targeted to those children infected prior to treatment.
Topics: Azithromycin; Humans; Anti-Bacterial Agents; Child, Preschool; Infant; Female; Trachoma; Male; Longitudinal Studies; Chlamydia trachomatis; Treatment Outcome; Chlamydia Infections; Niger; Infant, Newborn
PubMed: 38507803
DOI: 10.4269/ajtmh.23-0540 -
International Journal of Molecular... Feb 2024The increase in bacterial resistance to antibiotics in recent years demands innovative strategies for the detection and combating of biofilms, which are notoriously...
The increase in bacterial resistance to antibiotics in recent years demands innovative strategies for the detection and combating of biofilms, which are notoriously resilient. Biofilms, particularly those on contact lenses, can lead to biofilm-related infections (e.g., conjunctivitis and keratitis), posing a significant risk to patients. Non-destructive and non-contact sensing techniques are essential in addressing this threat. Digital holographic tomography emerges as a promising solution. This allows for the 3D reconstruction of the refractive index distribution in biological samples, enabling label-free visualization and the quantitative analysis of biofilms. This tool provides insight into the dynamics of biofilm formation and maturation on the surface of transparent materials. Applying digital holographic tomography for biofilm examination has the potential to advance our ability to combat the antibiotic bacterial resistance crisis. A recent study focused on characterizing biofilm formation and maturation on six soft contact lens materials (three silicone hydrogels, three hydrogels), with a particular emphasis on and , both common culprits in ocular infections. The results revealed species- and time-dependent variations in the refractive indexes and volumes of biofilms, shedding light on cell dynamics, cell death, and contact lens material-related factors. The use of digital holographic tomography enables the quantitative analysis of biofilm dynamics, providing us with a better understanding and characterization of bacterial biofilms.
Topics: Humans; Biofilms; Bacteria; Anti-Bacterial Agents; Hydrogels; Contact Lenses, Hydrophilic; Pseudomonas aeruginosa
PubMed: 38473902
DOI: 10.3390/ijms25052653