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Kong W, Ding G, Cheng G, Yang P, Xu Z. Mucosal immune responses to Ichthyophthirius multifiliis in the ocular mucosa of rainbow trout ( Oncorhynchus mykiss, Walbaum), an ancient teleost fish. MARINE LIFE SCIENCE & TECHNOLOGY 2024; 6:266-279. [PMID: 38827132 PMCID: PMC11136906 DOI: 10.1007/s42995-023-00199-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/16/2023] [Indexed: 06/04/2024]
Abstract
The eye, as a specialized visual organ, is directly exposed to the external environment, and, therefore, it faces constant challenges from external pathogenic organisms and toxins. In the ocular mucosa (OM) of mammals, mucosal-associated lymphoid tissues (MALTs) constitute the primary line of defense. However, the immune defense role of the OM remains unknown in aquatic vertebrates. To gain insights into the immune processes within the OM of teleost fish, we developed an infection model of rainbow trout (Oncorhynchus mykiss) OM using a parasite, Ichthyophthirius multifiliis (Ich). Immunofluorescence, qPCR, and H&E staining revealed that Ich successfully infiltrates the OM of rainbow trout, leading to pathological structural changes, as evidenced by A&B staining. Importantly, the qPCR results indicate an up-regulation of immune-related genes following Ich infection in the OM. Moreover, transcriptome analyses were conducted to detect immune responses and impairments in eye function within the OM of rainbow trout with Ich infection. The results of the transcriptome analysis that Ich infection can cause an extensive immune response in the OM, ultimately affecting ocular function. To the best of our knowledge, our findings represent for the first time that the teleost OM could act as an invasion site for parasites and trigger a strong mucosal immune response to parasitic infection. Supplementary Information The online version contains supplementary material available at 10.1007/s42995-023-00199-6.
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Affiliation(s)
- Weiguang Kong
- Key Laboratory of Breeding Biotechnology and Sustainable Aquaculture, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, 430072 China
| | - Guangyi Ding
- Key Laboratory of Breeding Biotechnology and Sustainable Aquaculture, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, 430072 China
| | - Gaofeng Cheng
- Department of Aquatic Animal Medicine, College of Fisheries, Huazhong Agricultural University, Wuhan, 430070 China
| | - Peng Yang
- Key Laboratory of Breeding Biotechnology and Sustainable Aquaculture, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, 430072 China
| | - Zhen Xu
- Key Laboratory of Breeding Biotechnology and Sustainable Aquaculture, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, 430072 China
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Elibol ES, Habip Z, Elbay A, Cırık AA, Oğuz H. Conjunctival and nasal microflora in patients on topical cyclosporine for dry eye. Int J Immunopathol Pharmacol 2024; 38:3946320241227103. [PMID: 38323796 PMCID: PMC10851765 DOI: 10.1177/03946320241227103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/03/2024] [Indexed: 02/08/2024] Open
Abstract
Introduction: Dry eye is a common ocular condition causing discomfort and visual disturbances. Anti-inflammatory agents like Cyclosporine A (CsA) are often used in its treatment. However, the impact of CsA on ocular flora remains understudied. This research aimed to evaluate changes in conjunctival and nasal microflora in patients receiving topical cyclosporine for dry eye. Methods: In this cross-sectional study, conjunctival and nasal samples were collected from two groups of dry eye patients. Group 1 consisted of 38 patients using CsA eye drops, while Group 2 included 34 patients using preservative-free artificial tear drops. Bacterial cultures were grown from the samples, and the identified organisms underwent antibiotic susceptibility testing. Additionally, alpha diversity metrics were employed to assess the diversity of bacterial species in the samples. Results: Bacterial growth was observed in 75% of conjunctival samples and 97.22% of nasal samples. Staphylococcus epidermidis was the predominant organism in both groups. Alpha diversity analysis showed no significant differences in Shannon diversity and OTU richness between the groups for most bacterial species. Antibiotic susceptibility tests revealed no substantial variations in resistance patterns between the groups. Conclusion: This study provides valuable insights into the impact of CsA eye drops on conjunctival and nasal flora in dry eye patients. The findings suggest that CsA does not significantly influence the composition, diversity, or antibiotic resistance patterns of ocular flora. Long-term topical cyclosporine treatment for dry eye does not significantly impact conjunctival microflora or lead to antibiotic resistance. These results have important implications for the safe use of CsA in patients undergoing ocular treatments, particularly those at risk of intraocular infections.
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Affiliation(s)
- Emine S Elibol
- Department Of Ophtalmology, Bahçeşehir University, Göztepe Medikalpark Hospital, İstanbul, Turkey
| | - Zafer Habip
- Medeniyet University, Göztepe Training and Research Hospital, Medical Microbiology Department, İstanbul, Turkey
- Department Of Ophtalmology, Göztepe Training and Research Hospital, Medeniyet University, İstanbul, Turkey
| | - Ahmet Elbay
- Department Of Ophtalmology, Bezmialem University, İstanbul, Turkey
| | - Ahmet Adnan Cırık
- Department Of Otorhinolaringology, Ümraniye Training and Research Hospital, Sağlık Bilimleri University, İstanbul, Turkey
| | - Halit Oğuz
- Medeniyet University, Göztepe Training and Research Hospital, Medical Microbiology Department, İstanbul, Turkey
- Department Of Ophtalmology, Göztepe Training and Research Hospital, Medeniyet University, İstanbul, Turkey
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Tieu S, Charchoglyan A, Paulsen L, Wagter-Lesperance LC, Shandilya UK, Bridle BW, Mallard BA, Karrow NA. N-Acetylcysteine and Its Immunomodulatory Properties in Humans and Domesticated Animals. Antioxidants (Basel) 2023; 12:1867. [PMID: 37891946 PMCID: PMC10604897 DOI: 10.3390/antiox12101867] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
N-acetylcysteine (NAC), an acetylated derivative of the amino acid L-cysteine, has been widely used as a mucolytic agent and antidote for acetaminophen overdose since the 1960s and the 1980s, respectively. NAC possesses antioxidant, cytoprotective, anti-inflammatory, antimicrobial, and mucolytic properties, making it a promising therapeutic agent for a wide range of diseases in both humans and domesticated animals. Oxidative stress and inflammation play a major role in the onset and progression of all these diseases. NAC's primary role is to replenish glutathione (GSH) stores, the master antioxidant in all tissues; however, it can also reduce levels of pro-inflammatory tumor necrosis factor-alpha (TNF-∝) and interleukins (IL-6 and IL-1β), inhibit the formation of microbial biofilms and destroy biofilms, and break down disulfide bonds between mucin molecules. Many experimental studies have been conducted on the use of NAC to address a wide range of pathological conditions; however, its effectiveness in clinical trials remains limited and studies often have conflicting results. The purpose of this review is to provide a concise overview of promising NAC usages for the treatment of different human and domestic animal disorders.
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Affiliation(s)
- Sophie Tieu
- Department of Animal Biosciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (S.T.); (U.K.S.)
- Department of Pathobiology, University of Guelph, Guelph, ON N1G 2W1, Canada; (L.P.); (L.C.W.-L.); (B.W.B.); (B.A.M.)
| | - Armen Charchoglyan
- ImmunoCeutica Inc., Cambridge, ON N1T 1N6, Canada
- Advanced Analysis Centre, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Lauryn Paulsen
- Department of Pathobiology, University of Guelph, Guelph, ON N1G 2W1, Canada; (L.P.); (L.C.W.-L.); (B.W.B.); (B.A.M.)
| | - Lauri C. Wagter-Lesperance
- Department of Pathobiology, University of Guelph, Guelph, ON N1G 2W1, Canada; (L.P.); (L.C.W.-L.); (B.W.B.); (B.A.M.)
- ImmunoCeutica Inc., Cambridge, ON N1T 1N6, Canada
| | - Umesh K. Shandilya
- Department of Animal Biosciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (S.T.); (U.K.S.)
| | - Byram W. Bridle
- Department of Pathobiology, University of Guelph, Guelph, ON N1G 2W1, Canada; (L.P.); (L.C.W.-L.); (B.W.B.); (B.A.M.)
- ImmunoCeutica Inc., Cambridge, ON N1T 1N6, Canada
| | - Bonnie A. Mallard
- Department of Pathobiology, University of Guelph, Guelph, ON N1G 2W1, Canada; (L.P.); (L.C.W.-L.); (B.W.B.); (B.A.M.)
- ImmunoCeutica Inc., Cambridge, ON N1T 1N6, Canada
| | - Niel A. Karrow
- Department of Animal Biosciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (S.T.); (U.K.S.)
- ImmunoCeutica Inc., Cambridge, ON N1T 1N6, Canada
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Barbalho GN, Falcão MA, Lopes JMS, Lopes JM, Contarato JLA, Gelfuso GM, Cunha-Filho M, Gratieri T. Dynamic Ex Vivo Porcine Eye Model to Measure Ophthalmic Drug Penetration under Simulated Lacrimal Flow. Pharmaceutics 2023; 15:2325. [PMID: 37765293 PMCID: PMC10534681 DOI: 10.3390/pharmaceutics15092325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Animal models are still used in the research and development of ophthalmic drug products, mainly due to the difficulty in simulating natural physiological conditions with in vitro models, as there is a lack of dynamic protection mechanisms. Therefore, developing alternative ophthalmic models that evaluate drug penetration in the cornea while applying dynamic protection barriers is a contemporary challenge. This study aimed to develop a dynamic ex vivo model using porcine eyes with a simulated lacrimal flow to evaluate the performance of pharmaceutical drug products. A glass donor cell to support a simulated tear flow was designed, optimized, and custom-made. The system was challenged with different formulations (with fluconazole) including excipients with different viscosities (poloxamer 407) and mucoadhesive properties (chitosan). The results were compared to those obtained from a conventional excised cornea model mounted in Franz-type diffusion cells. The dynamic model could differentiate formulations, while the static model did not, overestimating ex vivo drug penetrated amounts. Hence, the dynamic model with simulated tear flow showed to be a simple and promising new alternative method for the drug penetration of ophthalmic formulations that ultimately can reduce the number of animals used in research.
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Affiliation(s)
- Geisa N Barbalho
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, Brasília 70910-900, DF, Brazil
| | - Manuel A Falcão
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, Brasília 70910-900, DF, Brazil
| | | | - Júlia M Lopes
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, Brasília 70910-900, DF, Brazil
| | - Jonad L A Contarato
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, Brasília 70910-900, DF, Brazil
| | - Guilherme M Gelfuso
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, Brasília 70910-900, DF, Brazil
| | - Marcilio Cunha-Filho
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, Brasília 70910-900, DF, Brazil
| | - Tais Gratieri
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, Brasília 70910-900, DF, Brazil
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Kirkegaard MK. Ocular adnexal lymphoma: Subtype‐specific clinical and genetic features. Acta Ophthalmol 2022; 100 Suppl 270:3-37. [DOI: 10.1111/aos.15248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Marina Knudsen Kirkegaard
- Department of Pathology, Eye Section, Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
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Comparative Study of Ocular Pharmacokinetics of Topical 0.3% Gatifloxacin Eye Gel and Solution in Rabbits. Antibiotics (Basel) 2022; 11:antibiotics11040502. [PMID: 35453253 PMCID: PMC9027311 DOI: 10.3390/antibiotics11040502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/16/2022] Open
Abstract
Few articles have reported drug concentrations of different ophthalmic dosage forms in the ocular tissues. This study aimed to determine the ocular pharmacokinetics of gatifloxacin 0.3% eye gel (GTX-Gel) and gatifloxacin 0.3% eye solution (GTX-Sol) at different time intervals after topical instillation in rabbits. A total of 126 healthy New Zealand rabbits were included, of which six rabbits did not receive antibiotics (control group). The remaining rabbits were randomly divided into four groups. GTX-Gel and GTX-Sol (50 μL) were topically instilled every hour in groups A1 and B1, respectively, and every two hours in groups A2 and B2, respectively, for 12 h. Ocular tissues were collected 2, 4, 8, 12, and 24 h after administration. Gatifloxacin concentration was measured using high-performance liquid chromatography coupled with tandem mass spectrometry. The drug reached peak concentrations (Cmax) in all tissues at 8−12 h. With the same administration frequency, the Cmax was higher with GTX-Gel than with GTX-Sol (p < 0.05). Except for the iris-ciliary body, other ocular tissues did not show significant difference (p > 0.05) in gatifloxacin concentration between either pair of groups. Gatifloxacin ophthalmic gel was found to attain significantly higher concentrations than the ophthalmic solution in ocular tissues.
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Choi YM, Kim N. Frontalis Sling Using a Silicone Rod for Ptosis in Third Nerve Palsy: Cosmesis Versus Safety. KOREAN JOURNAL OF OPHTHALMOLOGY 2022; 36:159-167. [PMID: 35067023 PMCID: PMC9013560 DOI: 10.3341/kjo.2021.0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/13/2021] [Indexed: 12/01/2022] Open
Abstract
Purpose To evaluate the results of the frontalis sling operation using a silicone rod for the correction of ptosis in patients with third nerve palsy with a focus on corneal safety. Methods Patients with third nerve palsy who underwent the frontalis sling operation using a silicone rod between 2008 and 2019 were included in this study. The medical records of all patients were reviewed, and their clinical characteristics and postoperative outcomes were analyzed. In this retrospective, interventional case series, the main outcome measures were eyelid contour, eyelid height by margin reflex distance, and corneal status. Results Twenty-four eyes of 18 patients (12 male and six female patients) were included. The mean age at the time of surgery was 35.1 years (range, 5–64 years). Twelve patients underwent a unilateral ptosis operation, and six patients received a bilateral ptosis operation. The mean follow-up period was 32.1 months (range, 2–87 months). Most patients (21 of 24 eyes, 88%) showed poor Bell’s phenomenon on preoperative examination. Satisfactory eyelid height and eyelid contour were achieved in almost all patients (mean postoperative margin reflex distance, +1.2 mm) postoperatively. Although corneal erosions were detected for several months in eight of 24 eyes after surgery, these findings were well controlled medically with artificial tear eye drops and ointments. Conclusions Frontalis sling surgery using a silicone rod can safely and effectively correct ptosis without severe corneal complications in patients with third nerve palsy. Our study outlines a new method to define the postoperative safety outcome by specifically focusing on categorized corneal status.
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Affiliation(s)
- Yong Min Choi
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Namju Kim
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea
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The effect of topical ocular moxifloxacin on conjunctival and nasal mucosal flora. Sci Rep 2021; 11:13782. [PMID: 34215812 PMCID: PMC8253760 DOI: 10.1038/s41598-021-93233-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 06/22/2021] [Indexed: 11/16/2022] Open
Abstract
To determine the short-term effect of topically administered ocular moxifloxacin on conjunctival and nasal bacterial mucosal flora. The study included 20 patients with newly diagnosed age-related macular degeneration. Each patient’s diseased eye was selected as the treatment eye and the fellow eye was selected as the control eye. All treatment eyes constituted the treatment group and all controls eyes constituted the control group. All patients received intravitreal injection of ranibizumab. Cultures were obtained from the inferior conjunctival fornix and the nostrils in all patients. Patients were instructed to administer moxifloxacin eye drops to the treatment eye 4 times daily for 1 week. The patients were instructed to come for a follow-up exam 1 week post intravitreal injection. The bacterial culture positivity rate and the bacteria isolated from the conjunctiva and nostrils were recorded in the 2 groups before and after use of topical ocular moxifloxacin. Mean age of the patients (12 female and 8 male) was 64.9 years. Before use of topical ocular moxifloxacin the conjunctival and nasal culture positivity rates in the treatment group were both 100%, versus 90% and 95%, respectively, in the control group. At the follow-up exam the conjunctival and nasal mucosa culture positivity rates in the treatment group decreased to 20% (4/20) and 30% (6/20), respectively (P < 0.001), versus 85% (17/20) and 80% (16/20), respectively, in the control group (P = 0.68 and P = 0.72 for conjunctival and nasal). This is the first study to show that moxifloxacin applied to the ocular surface topically has a significant effect on nasal flora. Daily administration of topical ocular moxifloxacin for 1 week significantly reduces the nasal bacterial flora in addition to conjunctival flora.
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Konduri R, Saiabhilash CR, Shivaji S. Biofilm-Forming Potential of Ocular Fluid Staphylococcus aureus and Staphylococcus epidermidis on Ex Vivo Human Corneas from Attachment to Dispersal Phase. Microorganisms 2021; 9:microorganisms9061124. [PMID: 34067392 PMCID: PMC8224674 DOI: 10.3390/microorganisms9061124] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/14/2022] Open
Abstract
The biofilm-forming potential of Staphylococcus aureus and Staphylococcus epidermidis, isolated from patients with Endophthalmitis, was monitored using glass cover slips and cadaveric corneas as substrata. Both the ocular fluid isolates exhibited biofilm-forming potential by the Congo red agar, Crystal violet and 2,3-bis (2-methoxy-4-nitro-5-sulfophenyl)-5-(phenylamino) carbonyl-2H-tetra-zolium hydroxide (XTT) methods. Confocal microscopy demonstrated that the thickness of the biofilm increased from 4–120 h of biofilm formation. Scanning electron microscopic studies indicated that the biofilms grown on cover slips and ex vivo corneas of both the isolates go through an adhesion phase at 4 h followed by multilayer clumping of cells with intercellular connections and copious amounts of extracellular polymeric substance. Clumps subsequently formed columns and eventually single cells were visible indicative of dispersal phase. Biofilm formation was more rapid when the cornea was used as a substratum. In the biofilms grown on corneas, clumping of cells, formation of 3D structures and final appearance of single cells indicative of dispersal phase occurred by 48 h compared to 96–120 h when biofilms were grown on cover slips. In the biofilm phase, both were several-fold more resistant to antibiotics compared to planktonic cells. This is the first study on biofilm forming potential of ocular fluid S. aureus and S. epidermidis on cadaveric cornea, from attachment to dispersal phase of biofilm formation.
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Downie LE, Bandlitz S, Bergmanson JPG, Craig JP, Dutta D, Maldonado-Codina C, Ngo W, Siddireddy JS, Wolffsohn JS. CLEAR - Anatomy and physiology of the anterior eye. Cont Lens Anterior Eye 2021; 44:132-156. [PMID: 33775375 DOI: 10.1016/j.clae.2021.02.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 02/06/2023]
Abstract
A key element of contact lens practice involves clinical evaluation of anterior eye health, including the cornea and limbus, conjunctiva and sclera, eyelids and eyelashes, lacrimal system and tear film. This report reviews the fundamental anatomy and physiology of these structures, including the vascular supply, venous drainage, lymphatic drainage, sensory innervation, physiology and function. This is the foundation for considering the potential interactions with, and effects of, contact lens wear on the anterior eye. This information is not consistently published as academic research and this report provides a synthesis from all available sources. With respect to terminology, the report aims to promote the consistent use of nomenclature in the field, and generally adopts anatomical terms recommended by the Federative Committee for Anatomical Terminology. Techniques for the examination of the ocular surface are also discussed.
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Affiliation(s)
- Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Australia.
| | - Stefan Bandlitz
- Höhere Fachschule für Augenoptik Köln, Cologne School of Optometry, Germany; School of Optometry, Aston University, Birmingham, UK
| | - Jan P G Bergmanson
- Texas Eye Research and Technology Center, University of Houston College of Optometry, United States
| | - Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand
| | - Debarun Dutta
- School of Optometry, Aston University, Birmingham, UK
| | - Carole Maldonado-Codina
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, UK
| | - William Ngo
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada; Centre for Eye and Vision Research (CEVR), 14W Hong Kong Science Park, Hong Kong
| | | | - James S Wolffsohn
- School of Optometry, Aston University, Birmingham, UK; Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand
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de Freitas Santoro D, de Sousa LB, Câmara NOS, de Freitas D, de Oliveira LA. SARS-COV-2 and Ocular Surface: From Physiology to Pathology, a Route to Understand Transmission and Disease. Front Physiol 2021; 12:612319. [PMID: 33643063 PMCID: PMC7907452 DOI: 10.3389/fphys.2021.612319] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/22/2021] [Indexed: 12/14/2022] Open
Abstract
Coronaviruses gained public attention during the severe acute respiratory syndrome (SARS) outbreak in East Asia in 2003 and spread of Middle Eastern respiratory syndrome (MERS) in 2012. Direct human-to-human contact and droplet are the main methods of transmission. Viral stability in aerosols on different surfaces supports evidence on indirect viral acquisition from fomites through the mucous membranes of the mouth, nose, and eyes. Given the pandemic circumstances, the level of evidence in COVID-19 and ophthalmology regarding eye infection, conjunctival transmission, and viral shedding through tears is insufficient. Presently, conjunctival transmission of coronaviruses has not been confirmed and remains controversial. Considering the physiology of the lacrimal system and ocular surface, the eyes are considered an immunoprotective site, with several antiviral molecules and anti-inflammatory proteins. Nevertheless, they represent an interface with the exterior world and face daily putative aggressors. Understanding the host's ocular surface immunological and protective environment is crucial to clarify the potential of the conjunctiva as an entry route for SARS-CoV-2 and as part of this viral infection. We will discuss hypothetical ocular surface transmission mechanisms and related counterarguments addressed to both angiotensin-converting enzyme 2 receptors found on the conjunctival and corneal epithelia and lactoferrin, lysozyme, lipocalin and secretory IgA levels in the tear film. Hopefully, we will promote better understanding of this organ in COVID-19 infection and the potential transmission route that can be helpful in setting recommendations on best practices and protective guidelines to mitigate the disease spread.
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Affiliation(s)
| | - Luciene Barbosa de Sousa
- Department of Ophthalmology and Visual Science, Federal University of São Paulo, São Paulo, Brazil
| | - Niels O. S. Câmara
- Department of Immunology, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil
- Nephrology Division, Federal University of São Paulo, São Paulo, Brazil
| | - Denise de Freitas
- Department of Ophthalmology and Visual Science, Federal University of São Paulo, São Paulo, Brazil
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Meduri A, Oliverio GW, Mancuso G, Giuffrida A, Guarneri C, Venanzi Rullo E, Nunnari G, Aragona P. Ocular surface manifestation of COVID-19 and tear film analysis. Sci Rep 2020; 10:20178. [PMID: 33214658 PMCID: PMC7677531 DOI: 10.1038/s41598-020-77194-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 11/05/2020] [Indexed: 01/03/2023] Open
Abstract
To evaluate the ocular manifestation in patients hospitalized with coronavirus disease 2019 (COVID-19) and to search for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in tears. This study was conducted in 29 hospitalized patients who were admitted to the COVID center at the Policlinic Hospital of the University of Messina, Italy. All patients underwent an ophthalmologic assessment comprising a Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire, anterior segment, and the ocular surface examination of both eyes using a portable slit lamp. The Schirmer I test was performed, and the filter paper strip was used to search for the presence of SARS-CoV-2 on the ocular surface by real-time quantitative polymerase chain reaction (RT-qPCR). A total of 10 patients reported ocular symptoms; in particular, four reported eye burning, three reported foreign body sensation, and three reported tearing. Moreover, seven patients presented conjunctival hyperemia and/or chemosis, eleven patients presented blepharitis signs such as lid margin hyperemia and/or telangiectasia, crusted eyelashes, and meibomian orifices alterations. Tear analysis did not reveal the presence of SARS-CoV-2. Ocular symptoms are common in patients with COVID-19; although, tear analysis did not reveal the presence of SARS-CoV-2.
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Affiliation(s)
- Alessandro Meduri
- Biomedical Science Department, Institute of Ophthalmology, University of Messina, Via Consolare Valeria, 1, Messina, Italy.
| | - Giovanni William Oliverio
- Biomedical Science Department, Institute of Ophthalmology, University of Messina, Via Consolare Valeria, 1, Messina, Italy
| | - Giuseppe Mancuso
- Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi" Division of Microbiology, University of Messina, Messina, Italy
| | - Angela Giuffrida
- Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi" Division of Microbiology, University of Messina, Messina, Italy
| | - Claudio Guarneri
- Biomedical Science Department, Institute of Ophthalmology, University of Messina, Via Consolare Valeria, 1, Messina, Italy
| | - Emmanuele Venanzi Rullo
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, A.O.U. "G. Martino", University of Messina, Messina, Italy
| | - Giuseppe Nunnari
- Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi" Division of Microbiology, University of Messina, Messina, Italy
| | - Pasquale Aragona
- Biomedical Science Department, Institute of Ophthalmology, University of Messina, Via Consolare Valeria, 1, Messina, Italy
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O'Leary OE, Schoetzau A, Amruthalingam L, Geber-Hollbach N, Plattner K, Jenoe P, Schmidt A, Ullmer C, Drawnel FM, Fauser S, Scholl HPN, Passweg J, Halter JP, Goldblum D. Tear Proteomic Predictive Biomarker Model for Ocular Graft Versus Host Disease Classification. Transl Vis Sci Technol 2020; 9:3. [PMID: 32879760 PMCID: PMC7442883 DOI: 10.1167/tvst.9.9.3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/26/2020] [Indexed: 12/20/2022] Open
Abstract
Purpose Diagnosis of ocular graft-versus-host disease (oGVHD) is hampered by a lack of clinically-validated biomarkers. This study aims to predict disease severity on the basis of tear protein expression in mild oGVHD. Methods Forty-nine patients with and without chronic oGVHD after AHCT were recruited to a cross-sectional observational study. Patients were stratified using NIH guidelines for oGVHD severity: NIH 0 (none; n = 14), NIH 1 (mild; n = 9), NIH 2 (moderate; n = 16), and NIH 3 (severe; n = 10). The proteomic profile of tears was analyzed using liquid chromatography-tandem mass spectrometry. Random forest and penalized logistic regression were used to generate classification and prediction models to stratify patients according to disease severity. Results Mass spectrometry detected 785 proteins across all samples. A random forest model used to classify patients by disease grade achieved F1-measure values for correct classification of 0.95 (NIH 0), 0.8 (NIH 1), 0.74 (NIH 2), and 0.83 (NIH 3). A penalized logistic regression model was generated by comparing patients without oGVHD and those with mild oGVHD and applied to identify potential biomarkers present early in disease. A panel of 13 discriminant markers achieved significant diagnostic accuracy in identifying patients with moderate-to-severe disease. Conclusions Our work demonstrates the utility of tear protein biomarkers in classifying oGVHD severity and adds further evidence indicating ocular surface inflammation as a main driver of oGVHD clinical phenotype. Translational Relevance Expression levels of a 13-marker tear protein panel in AHCT patients with mild oGVHD may predict development of more severe oGVHD clinical phenotypes.
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Affiliation(s)
- Olivia E O'Leary
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Andreas Schoetzau
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Nadine Geber-Hollbach
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Kim Plattner
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Paul Jenoe
- Proteomics Core Facility, Biozentrum, University of Basel, Basel, Switzerland
| | - Alexander Schmidt
- Proteomics Core Facility, Biozentrum, University of Basel, Basel, Switzerland
| | - Christoph Ullmer
- Pharma Research and Early Development, Roche Innovation Center, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Faye M Drawnel
- Pharma Research and Early Development, Roche Innovation Center, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Sascha Fauser
- Pharma Research and Early Development, Roche Innovation Center, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Hendrik P N Scholl
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland.,Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland.,Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
| | - Jakob Passweg
- Department of Hematology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Joerg P Halter
- Department of Hematology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - David Goldblum
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
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Holm F, Mikkelsen LH, Kamper P, Rasmussen PK, Larsen TS, Sjö LD, Heegaard S. Ocular adnexal lymphoma in Denmark: a nationwide study of 387 cases from 1980 to 2017. Br J Ophthalmol 2020; 105:914-920. [PMID: 32732342 DOI: 10.1136/bjophthalmol-2019-315637] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 06/09/2020] [Accepted: 07/03/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Nationwide studies of ocular adnexal lymphoma (OAL) are very rare in the literature, and knowledge on incidence, subtype distribution and long-term survival data is limited. This is the largest national study of OAL to date. This study sought to find information on incidence, changes in incidence, clinical findings, distribution of subtypes, survival and prognostic factors. METHODS Patients diagnosed with OAL from January 1, 1980 to December 31, 2017 were identified in Danish registers, and clinical as well as survival data were collected. The data were analysed with Kaplan-Meier plots and log-rank test. RESULTS 387 patients were included in the study. The major lymphoma subtypes were extranodal marginal-zone B cell lymphoma (EMZL) (55%), diffuse large B cell lymphoma (DLBCL) (13%), mantle cell lymphoma (MCL) (11%) and follicular lymphoma (FL) (10%). OAL is a disease of the elderly (median age 69 years). The incidence of lymphoma of the ocular adnexal region has increased significantly throughout the time period of the study (Pearson correlation coefficient, r=0.65; P<0.001). In the period 1980-1984, the incidence was 0.086 per 100 000, which increased to 0.307 per 100 000 in the period 2013-2017. Low-grade, low-stage primary lymphomas were treated with radiotherapy, whereas patients with high-stage, high-grade and/or relapsed disease were treated with chemotherapy. Low-grade subtypes EMZL (89%) and FL (56%) had better 10-year disease-specific survival than the high-grade lymphomas DLBCL (38%) and MCL (31%)(p<0.001). CONCLUSION OAL is increasing in incidence in the Danish population for unknown reasons. However, the prognosis for most OAL is favourable, as highlighted in this national long-term study.
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Affiliation(s)
- Frederik Holm
- Department of Pathology, Eye Pathology Section, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lauge Hjorth Mikkelsen
- Department of Pathology, Eye Pathology Section, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Peter Kamper
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Kristian Rasmussen
- Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
| | | | - Lene Dissing Sjö
- Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Heegaard
- Department of Pathology, Eye Pathology Section, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark .,Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
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15
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Bispo PJM, Ung L, Chodosh J, Gilmore MS. Hospital-Associated Multidrug-Resistant MRSA Lineages Are Trophic to the Ocular Surface and Cause Severe Microbial Keratitis. Front Public Health 2020; 8:204. [PMID: 32582610 PMCID: PMC7283494 DOI: 10.3389/fpubh.2020.00204] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 05/05/2020] [Indexed: 12/02/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of severe and difficult to treat ocular infection. In this study, the population structure of 68 ocular MRSA isolates collected at Massachusetts Eye and Ear between January 2014 and June 2016 was assessed. By using a combination of multilocus sequence typing (MLST) analysis, SCCmec typing and detection of the panton-valentine leukocidin (PVL) gene, we found that the population structure of ocular MRSA is composed of lineages with community and hospital origins. As determined by eBURST analysis of MLST data, the ocular MRSA population consisted of 14 different sequence types (STs) that grouped within two predominant clonal complexes: CC8 (47.0%) and CC5 (41.2%). Most CC8 strains were ST8, harbored type IV SCCmec and were positive for the PVL-toxin (93.7%). The CC5 group was divided between strains carrying SCCmec type II (71.4%) and SCCmec type IV (28.6%). Remaining isolates grouped in 6 different clonal complexes with 3 isolates in CC6 and the other clonal complexes being represented by a single isolate. Interestingly, major MRSA CC5 and CC8 lineages were isolated from discrete ocular niches. Orbital and preseptal abscess/cellulitis were predominantly caused by CC8-SCCmec IV PVL-positive strains. In contrast, infections of the cornea, conjunctiva and lacrimal system were associated with the MDR CC5 lineage, particularly as causes of severe infectious keratitis. This niche specialization of MRSA is consistent with a model where CC8-SCCmec IV PVL-positive strains are better adapted to cause infections of the keratinized and soft adnexal eye tissues, whereas MDR CC5 appear to have greater ability in overcoming innate defense mechanisms of the wet epithelium of the ocular surface.
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Affiliation(s)
- Paulo J M Bispo
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, United States.,Infectious Disease Institute, Harvard Medical School, Boston, MA, United States
| | - Lawson Ung
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, United States.,Infectious Disease Institute, Harvard Medical School, Boston, MA, United States
| | - James Chodosh
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, United States.,Infectious Disease Institute, Harvard Medical School, Boston, MA, United States
| | - Michael S Gilmore
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, United States.,Infectious Disease Institute, Harvard Medical School, Boston, MA, United States.,Department of Microbiology and Immunobiology, Harvard Medical School, Boston, MA, United States
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16
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In Vitro Models of Eye Infection with Neisseria gonorrhoeae. Methods Mol Biol 2020. [PMID: 31119634 DOI: 10.1007/978-1-4939-9496-0_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
Abstract
Prophylaxis with silver nitrate and later antibiotics has significantly reduced the cases of infant blindness from gonococcal infection at birth to the point where it has all but been forgotten in the developed world as the devastating disease that it was in the pre-antibiotic era. As a result, while it is known that the bacteria are transmitted to the eyes during passage through the infected birth canal, little is known about Neisseria gonorrhoeae colonization of the eye and the establishment and progression of keratitis. Treatment failures due to rising antimicrobial resistance necessitate investigations into all aspects of gonococcal disease, including eye infections, so that new treatment strategies can be developed. Here we present models for N. gonorrhoeae eye infection using excised bovine corneas and coculture of gonococci with primary human corneal epithelial cells. These models can be used to explore the interactions of the bacteria with corneal tissues and cells and to investigate novel therapeutics against infection.
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17
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Kıvanç SA, Arık G, Akova-Budak B, Kıvanç M. Biofilm forming capacity and antibiotic susceptibility of Staphylococcus spp. with the icaA/icaD/bap genotype isolated from ocular surface of patients with diabetes. Malawi Med J 2019; 30:243-249. [PMID: 31798802 PMCID: PMC6863420 DOI: 10.4314/mmj.v30i4.6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Introduction Bacterial biofilm is an exopolysaccharide matrix that is produced by bacteria while they adhere on abiotic or biotic surfaces. The bacteria living in this matrix are more resistant to antibiotics than planctonic bacteria. The biofilm formation property of the bacteria is determined by genes; and this is related to virulence of the microorganism. In ophthalmology, biofilms form especially on abiotic surfaces such as silicon tubes, contact lenses, intraocular lenses etc. Aim Our aim was to investigate genotypic and phenotypic structures of biofilms that are produced by Staphylococcus spp., which was obtained from the eyes of diabetic patients and determine the effect on antibiotic susceptibility. Methods The study group was comprised with 83 isolates from diabetic patients and 21 isolates from non-diabetic patients. Presumptive isolates were detected and confirmed by a microbial identification system VITEK II. Automated EcoRI Ribotyping was performed. Biofilm production was detected by Congo Red Agar Plate and Microtiter Plate Assay. Disc diffusion method was used for determination of antibiotic susceptibility of isolates. Results Out of the 83 isolates from diabetic patients, 25 were weakly (30%), 20 were moderately (24%), and 25 were strongly (30%) biofilm positive. Seven isolates of S. aureus, 11 isolates of S.epidermidis, 2 isolates of S. warneri, 3 isolates of S.hominis, and 2 isolates of S.lugdunensis were identified as strong biofilm producers. Out of the 83 Staphylococcus isolates, 37 were cefuroxime, 18 ciprofloxacin, 11 vancomycin, 12 gatifloxacin, and 18 moxifloxacin resistant. In total, 37 strains were resistant to three or more antibiotics. There was a statistically significant relation between biofilm formation and multidrug resistance (against three or more antibiotics, p<0.001). In nondiabetic patients, 15(71%) isolates were non adherent or weakly adherent, and 2(10%) were strongly adherent biofilm positive. Conclusion In conclusion, bacterial conjunctival flora of patients with diabetes is likely to produce biofilm. Biofilm formation is associated with multidrug rsistance in patients with diabetes.
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Affiliation(s)
- Sertaç Argun Kıvanç
- Uludag University, School of Medicine, Department of Ophthalmology, Görükle, Bursa/Turkey
| | - Gizem Arık
- Anadolu University, Faculty of Science, Department of Microbiology, Eskişehir/Turkey
| | - Berna Akova-Budak
- Uludag University, School of Medicine, Department of Ophthalmology, Görükle, Bursa/Turkey
| | - Merih Kıvanç
- Anadolu University, Faculty of Science, Department of Microbiology, Eskişehir/Turkey
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18
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Faghihi H, Rajaei SM, Ansari-mood M, Azizi F. CONJUNCTIVAL MICROFLORA IN GUINEA PIGS WITH AND WITHOUT SIGNS OF CONJUNCTIVITIS. J Exot Pet Med 2019. [DOI: 10.1053/j.jepm.2018.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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19
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Aftab G, Rajaei SM, Pot SA, Faghihi H. Seasonal Effects on the Corneoconjunctival Microflora in a Population of Persian Cats in Iran. Top Companion Anim Med 2019; 34:30-32. [DOI: 10.1053/j.tcam.2018.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/06/2018] [Accepted: 12/10/2018] [Indexed: 11/11/2022]
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20
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Ansari Mood M, Rajaei SM, Ashrafi Tamai I, Mansour Lakooraj H, Williams D. CORNEO-CONJUNCTIVAL MICROFLORA OF CLINICALLY NORMAL SYRIAN HAMSTERS (MESOCRICETUS AURATUS). J Exot Pet Med 2019. [DOI: 10.1053/j.jepm.2018.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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21
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Lacerda LCC, de Souza-Pollo A, Padua IRM, Conceição LF, da Silveira CPB, Silva GA, Maluta RP, Laus JL. Molecular characterization and potential sources of aqueous humor bacterial contamination during phacoemulsification with intraocular lens implantation in dogs. Vet Microbiol 2017; 213:95-101. [PMID: 29292010 DOI: 10.1016/j.vetmic.2017.11.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/17/2017] [Accepted: 11/18/2017] [Indexed: 11/29/2022]
Abstract
Bacterial contamination of the anterior chamber during cataract surgery is one of the main responsible for endophthalmitis postoperative. Phacoemulsification is a less invasive technique for cataract treatment, although it does not exclude the possibility of contamination. In this study, bacterial contaminants of aqueous humor collected pre- and post-phacoemulsification with intraocular lens implantation (IOL) of twenty dogs were identified. As the conjunctival microbiota constitute a significant source of anterior chamber contamination, bacterial isolates from aqueous humor were genetically compared with those present in the conjunctival surface of the patients. Three dogs presented bacterial growth in both aqueous humor and conjunctival surface samples. Bacterial isolates from these samples were grouped according to their genetic profiles by repetitive-element PCR (rep-PCR) and their representatives were identified by 16S rRNA sequencing. Isolates from conjunctival surface were identified as Enterobacter spp., Staphylococcus spp. and S. aureus; and from aqueous humor samples as Enterobacter spp., Pantoea spp., Streptococcus spp. and Staphylococcus spp., respectively in decreasing order of prevalence. According to the rep-PCR analysis, 16.6% of Enterobacter spp. isolates from conjunctival surface were genetically similar to those from aqueous humor. The rest of isolates encountered in aqueous humor were genetically distinct from those of conjunctival surface. The significant genetic diversity of bacterial isolates found in the aqueous humor samples after surgery denoted the possibility of anterior chamber contamination during phacoemulsification by bacteria not only from conjunctival surface but also from different sources related to surgical environment.
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Affiliation(s)
- Luciana C C Lacerda
- Department of Veterinary Clinic and Surgery, São Paulo State University-FCAV/UNESP, Jaboticabal, São Paulo, Brazil
| | - Andressa de Souza-Pollo
- Laboratory of Molecular Epidemiology, Department of Preventive Veterinary Medicine and Animal Reproduction, São Paulo State University-FCAV/UNESP, Jaboticabal, São Paulo, Brazil
| | - Ivan Ricardo M Padua
- Department of Veterinary Clinic and Surgery, São Paulo State University-FCAV/UNESP, Jaboticabal, São Paulo, Brazil
| | - Luciano F Conceição
- Department of Veterinary Clinic and Surgery, São Paulo State University-FCAV/UNESP, Jaboticabal, São Paulo, Brazil
| | | | - Germana A Silva
- Department of Veterinary Clinic and Surgery, São Paulo State University-FCAV/UNESP, Jaboticabal, São Paulo, Brazil
| | - Renato P Maluta
- Department of Genetics, Evolution and Bioagents, Institute of Biology, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - José L Laus
- Department of Veterinary Clinic and Surgery, São Paulo State University-FCAV/UNESP, Jaboticabal, São Paulo, Brazil
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Abstract
PURPOSE To investigate the microbial cause and antibiotic susceptibility of neonatal bacterial conjunctivitis in Korean patients in the 21st century. METHODS We retrospectively reviewed the medical records of patients diagnosed with neonatal bacterial conjunctivitis between January 2000 and December 2015. We recorded the organism, antibiotic susceptibility, and antibiotics used. RESULTS A total of 82 neonates were included in the study (53 males and 29 females), with a mean age of 17.5 ± 7.1 days. The most commonly isolated organisms were Staphylococcus aureus (43 cases, 52.4%), coagulase-negative staphylococci (11 cases, 13.4%), Staphylococcus epidermidis (11 cases, 13.4%), Serratia marcescens (4 cases, 4.9%), Pseudomonas aeruginosa (4 cases, 4.9%), and Enterobacter cloacae (3 cases, 3.7%). We found no cases of Neisseria gonorrhoeae or Chlamydia trachomatis infection. Resistance to methicillin (83.7%), macrolide (81.4%), and aminoglycoside (23.3%) was observed in patients with S. aureus infection. Conjunctivitis that did not improve with erythromycin or tobramycin generally improved with the additional use of tosufloxacin. CONCLUSIONS The prevalence of neonatal gonococcal or chlamydial conjunctivitis has decreased in the 21st century. However, methicillin-resistant S. aureus has been increasing, but these cases are responsive to tosufloxacin.
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23
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Novel peptide motifs from lysozyme suppress pro-inflammatory cytokines in macrophages by antagonizing toll-like receptor and LPS-scavenging action. Eur J Pharm Sci 2017; 107:240-248. [PMID: 28711715 DOI: 10.1016/j.ejps.2017.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 06/29/2017] [Accepted: 07/06/2017] [Indexed: 02/07/2023]
Abstract
Lysozyme is commonly found in spots where bacterial infections are most likely to enter the body. Earlier we found that lysozyme possesses five antimicrobial peptide motifs in its N-terminal region which can be generated by newborn pepsin. In this study, we explore the role of these peptides in the anti-inflammatory activity of lysozyme. The five peptides, helix1 (H1), helix2 (H2), H1 and H2 connected with a loop (HLH), H2 extended with either 2 β-strands (H2-S12) or 3 β-strands (H2-S13), were synthesized and examined for anti-inflammatory action. The five peptides dose-dependently decreased, to different degrees, expression of pro-inflammatory cytokines, TNF-α, IL-6 and IL-1β, in lipopolysaccharide (LPS)- or interferon-gamma (INF-γ)-stimulated mouse macrophage cells (RAW264.7). The HLH peptide and its individual helices (H1 and H2) were markedly the most potent anti-inflammatory. When macrophage cells were stimulated with live bacteria (E. coli), H1 peptide was the most powerful suppressor of TNF-α and IL-6 expression, providing evidence that the peptide is able to antagonize the pathogen-induced inflammatory response. Receptor binding assay and docking simulation provided evidence that H1 peptide bind specifically to the pocket for endotoxin binding of the toll-like receptor 4 (TLR-4) of macrophage. The results demonstrate, for the first time, the molecular basis of anti-inflammatory action of lysozyme that N-terminal helical peptides are the main contributors. This exciting finding offers new classes of therapeutic peptides with potential in the treatment of infection-induced inflammatory diseases.
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Fluctuation of Bacteria on Bleb Surface After Trabeculectomy With Adjunctive Mitomycin C. J Glaucoma 2016; 25:433-9. [DOI: 10.1097/ijg.0000000000000305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hindley KE, Groth AD, King M, Graham K, Billson FM. Bacterial isolates, antimicrobial susceptibility, and clinical characteristics of bacterial keratitis in dogs presenting to referral practice in Australia. Vet Ophthalmol 2015; 19:418-26. [PMID: 26522379 DOI: 10.1111/vop.12325] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To identify clinical characteristics, bacterial isolates, and their antimicrobial susceptibility patterns in a prospective study of dogs presenting with suspected bacterial keratitis to aid selection of appropriate therapy. ANIMALS Seventy-one client-owned dogs presenting to two referral hospitals in Australia. PROCEDURE Corneal swabs and clinical information were collected from dogs presenting with suspect bacterial keratitis from April 2012 to December 2014. Cytology and bacteriologic culture were performed on samples with in vitro antimicrobial susceptibility performed on bacterial isolates. RESULTS Positive cultures were obtained from 42 of the 71 ulcers sampled (59%), with 45 bacteria isolated. The most commonly isolated bacteria were β-hemolytic Streptococcus (14/45, 31%), Pseudomonas (14/45, 31%), and Staphylococcus species (8/45, 18%). β-Hemolytic Streptococcus spp. were resistant to neomycin, polymyxin B, gentamicin, framycetin and fusidic acid and >80% were resistant to ciprofloxacin but remained susceptible to chloramphenicol and cephalexin. Pseudomonas aeruginosa isolates were resistant to chloramphenicol, cephalexin, and fusidic acid; however, >90% were susceptible to ciprofloxacin, polymyxin B, and gentamicin. Brachycephalic breed (34/42, 81%), previous ocular surgery (15/42, 36%), prior use of a topical corticosteroid (13/42, 31%), and concurrent ocular surface disease (10/42, 24%) were common in dogs with bacterial keratitis. CONCLUSION Our study identified β-hemolytic Streptococcus and Pseudomonas spp. as the most common bacterial pathogens in canine bacterial keratitis presenting for referral. Many cases exhibited clinical factors known to influence corneal integrity that may predispose them to ulceration and infection. Based on in vitro antimicrobial susceptibility patterns and clinical outcomes, monotherapy with a fluoroquinolone may be ineffective in ulcers caused by β-hemolytic Streptococcus spp.
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Affiliation(s)
- Kate E Hindley
- Veterinary Ophthalmology, Small Animal Specialist Hospital, Lvl 1, 1 Richardson Place, North Ryde, 2113, NSW, Australia.
| | - Allyson D Groth
- Veterinary Ophthalmology, Small Animal Specialist Hospital, Lvl 1, 1 Richardson Place, North Ryde, 2113, NSW, Australia
| | - Martyn King
- Veterinary Ophthalmology, Rivergum Referral Services, Unit 1/26 Gympie Way, Willeton, 6155, WA, Australia
| | - Kathleen Graham
- Veterinary Ophthalmology, Small Animal Specialist Hospital, Lvl 1, 1 Richardson Place, North Ryde, 2113, NSW, Australia
| | - F Mark Billson
- Veterinary Ophthalmology, Small Animal Specialist Hospital, Lvl 1, 1 Richardson Place, North Ryde, 2113, NSW, Australia
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Alansari MA, Hijazi MH, Maghrabi KA. Making a Difference in Eye Care of the Critically Ill Patients. J Intensive Care Med 2015; 30:311-7. [PMID: 24212598 DOI: 10.1177/0885066613510674] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 07/19/2013] [Indexed: 11/16/2022]
Abstract
Ocular surface disorders are frequently encountered in patients under sedation and paralyzed patients in intensive care units (ICUs). In the ICUs, treatment is usually focused on the management of organ failures, and eye care becomes a side issue. As a result, ophthalmological complications do occur (incidence ranges from 3.6% to 60%) and are frequently overlooked in this setting. To identify the best available evidence in providing the best eye care to prevent exposure keratopathy, a literature review was performed. The databases of PUBMED, COCHRAN, and EMBASE library were searched. We only looked at higher quality articles. Among various eye care measures that have been advocated to prevent exposure keratopathy, the most effective is the application of polyethylene covers. Early diagnosis and effective treatment will help prevent microbial keratitis and visual loss.
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Affiliation(s)
- Mariam A Alansari
- Department of Adult Critical Care Medicine, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed H Hijazi
- Department of Critical Care Medicine (MBC 94), King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Khalid A Maghrabi
- Department of Critical Care Medicine (MBC 94), King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
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27
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Kanwar JR, Roy K, Patel Y, Zhou SF, Singh MR, Singh D, Nasir M, Sehgal R, Sehgal A, Singh RS, Garg S, Kanwar RK. Multifunctional iron bound lactoferrin and nanomedicinal approaches to enhance its bioactive functions. Molecules 2015; 20:9703-31. [PMID: 26016555 PMCID: PMC6272382 DOI: 10.3390/molecules20069703] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 05/13/2015] [Indexed: 02/08/2023] Open
Abstract
Lactoferrin (Lf), an iron-binding protein from the transferrin family has been reported to have numerous functions. Even though Lf was first isolated from milk, it is also found in most exocrine secretions and in the secondary granules of neutrophils. Antimicrobial and anti-inflammatory activity reports on lactoferrin identified its significance in host defense against infection and extreme inflammation. Anticarcinogenic reports on lactoferrin make this protein even more valuable. This review is focused on the structural configuration of iron-containing and iron-free forms of lactoferrin obtained from different sources such as goat, camel and bovine. Apart for emphasizing on the specific beneficial properties of lactoferrin from each of these sources, the general antimicrobial, immunomodulatory and anticancer activities of lactoferrin are discussed here. Implementation of nanomedicinial strategies that enhance the bioactive function of lactoferrin are also discussed, along with information on lactoferrin in clinical trials.
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Affiliation(s)
- Jagat R Kanwar
- Nanomedicine-Laboratory of Immunology and Molecular Biomedical Research (NLIMBR), School of Medicine (SoM), Molecular and Medical Research (MMR) Strategic Research Centre, Faculty of Health, Deakin University, Waurn Ponds, Victoria 3217, Australia.
| | - Kislay Roy
- Nanomedicine-Laboratory of Immunology and Molecular Biomedical Research (NLIMBR), School of Medicine (SoM), Molecular and Medical Research (MMR) Strategic Research Centre, Faculty of Health, Deakin University, Waurn Ponds, Victoria 3217, Australia.
| | - Yogesh Patel
- Nanomedicine-Laboratory of Immunology and Molecular Biomedical Research (NLIMBR), School of Medicine (SoM), Molecular and Medical Research (MMR) Strategic Research Centre, Faculty of Health, Deakin University, Waurn Ponds, Victoria 3217, Australia.
| | - Shu-Feng Zhou
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL 33612, USA.
| | - Manju Rawat Singh
- University Institute of Pharmacy, Pt. Ravishankar Shukla University, Raipur 492 010, India.
| | - Deependra Singh
- University Institute of Pharmacy, Pt. Ravishankar Shukla University, Raipur 492 010, India.
| | - Muhammad Nasir
- Department of Food Science & Human Nutrition, Faculty of Bio-Sciences, University of Veterinary & Animal Sciences, Lahore, Punjab 54000, Pakistan.
| | - Rakesh Sehgal
- Department of Medical Parasitology, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India.
| | - Alka Sehgal
- Department of Obstetrics & Gynecology, Government Medical College & Hospital, Sector 32, Chandigarh 160031, India.
| | - Ram Sarup Singh
- Carbohydrate and Protein Biotechnology Laboratory, Department of Biotechnology, Punjabi University, Patiala 147002, India.
| | - Sanjay Garg
- Centre for Pharmaceutical Innovation and Development (CPID), School of Pharmacy and Medical Sciences, University of South Australia, Adelaide SA 5000, Australia.
| | - Rupinder K Kanwar
- Nanomedicine-Laboratory of Immunology and Molecular Biomedical Research (NLIMBR), School of Medicine (SoM), Molecular and Medical Research (MMR) Strategic Research Centre, Faculty of Health, Deakin University, Waurn Ponds, Victoria 3217, Australia.
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DREYFUSS JULIANAL, REGATIERI CAIOV, COELHO BRUNO, BARBOSA JOSÉB, FREITAS DENISEDE, NADER HELENAB, MARTINS JOÃOR. Altered hyaluronic acid content in tear fluid of patients with adenoviral conjunctivitis. ACTA ACUST UNITED AC 2015; 87:455-62. [DOI: 10.1590/0001-3765201520140122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 10/24/2014] [Indexed: 01/14/2023]
Abstract
The adenoviral conjunctivitis is one of the biggest causes of conjunctival infection in the world. Conjunctivitis causes relatively nonspecific symptoms, as hyperaemia and chemosis. Even after biomicroscopy, complex laboratory tests, such as viral culture, are necessary to identify the pathogen or its etiology. To contribute to the better understanding of the pathobiology of the adenoviral conjunctivitis, the tear fluids of patients with unilateral acute adenovirus conjunctivitis (UAAC), normal donors (control) and patients with allergic conjunctivitis were analyzed. Tear samples were collected with Schirmer strips from control, allergic conjunctivitis and UAAC patients, diagnosed by clinical signs. UAAC tears were tested positive in viral cultures. After the elution, HA was quantified using an ELISA-like fluorometric assay and the protein profile was determined by SDS-PAGE. A profound increase in the HA tear content in UAAC patients was found when compared to control and ALC. This HA increase in UAAC tears remarkably was not observed in tears from contralateral eyes without clinical signs, nor in allergic conjunctivitis. In addition a distinct profile of UAAC tear proteins was observed in patients with UAAC. The quantification of HA in the tear fluid is a rapid, sensitive and specific test. This molecule might be a biomarker candidate for acute conjunctivitis.
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Affiliation(s)
- JULIANA L. DREYFUSS
- Universidade Federal de São Paulo, Brasil; Universidade Federal de São Paulo, Brasil
| | - CAIO V. REGATIERI
- Universidade Federal de São Paulo, Brasil; Universidade Federal de São Paulo, Brasil; New England Eye Center, USA
| | | | | | | | | | - JOÃO R. MARTINS
- Universidade Federal de São Paulo, Brasil; Universidade Federal de São Paulo, Brasil
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Abstract
Mucosal immunity defends the ocular surface against antigenic challenge and microbial invasion. The principal effector site is the lacrimal gland, where immunoglobulin A (IgA) antibodies are produced. Nasal-associated lymphoid tissue and posterior cervical lymph nodes function as major inductive sites for tear IgA responses. Neural connections and systemic hormones maintain the integrity and function of the ocular surface. Neuroenzyme activities in the lacrimal gland are influenced by ocular infections, leading to reduced expression of acetylcholine and modulation of receptors on acinar cells and on plasma cells, thereby decreasing fluid and immunoglobulin secretion. T lymphocyte-dependent responses result in production of interleukin-4 in lacrimal glands, thereby influencing cholinergic enzyme activity affecting immune processes and lacrimal physiology. Furthermore, neuropeptides released into lymphoid structures or inflamed tissues are chemotactic for antigen-presenting cells and affect their interactions with T cells. Thus, in developing therapeutic approaches for treating dry-eye conditions and vaccination strategies to elicit protective ocular mucosal immune responses, the entire lacrimal functional unit should be considered.
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Ataş M, Başkan B, Ozköse A, Mutlu Sarıgüzel F, Demircan S, Pangal E. Effects of moxifloxacin exposure on the conjunctival flora and antibiotic resistance profile following repeated intravitreal injections. Int J Ophthalmol 2014; 7:855-9. [PMID: 25349806 DOI: 10.3980/j.issn.2222-3959.2014.05.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 12/25/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate the effects of moxifloxacin exposure on the conjunctival flora and antibiotic resistance profile following repeated intravitreal injections. METHODS Seventy-two eyes of 36 patients [36 eyes in control group, 36 eyes in intravitreal injection (IVI) group] were enrolled in the study. All the eyes had at least one IVI and had diabetic macular edema (DME) or age-related macular degeneration (ARMD). Moxifloxacin was prescribed to all the patients four times a day for five days following injection. Conjunctival cultures were obtained from the lower fornix via standardized technique with every possible effort made to minimize contamination from the lids, lashes, or skin. Before the application of any ophthalmic medication, conjunctival cultures were obtained from both eyes using sterile cotton culture. An automated microbiology system was used to identify the growing bacteria and determine antibiotic sensitivity. RESULTS The bacterial cultures were isolated from 72 eyes of 36 patients, sixteen of whom patients (44.4%) were male and twenty (55.6%) were female. Average age was 68.4±9.0 (range 50-86). The average number of injections before taking cultures was 3.1+1.0. Forty-eight (66.7%) of 72 eyes had at least one significant organism. There was no bacterial growth in 8 (20.5%) of IVI eyes and in 16 (44.4%) of control eyes (P=0.03). Of the bacteria isolated from culture, 53.8% of coagulase negative staphylococci (CoNS) in IVI eyes and 47.2% CoNS in control eyes. This difference between IVI eyes and control eyes about bacteria isolated from culture was not statistically significant (P=0.2). Eleven of 25 bacteria (44.0%) isolated from IVI eyes and 11 (57.9%) of 19 bacteria isolated from control eyes were resistant to oxacillin. The difference in frequency of moxifloxacine resistance between two groups was not statistically significant (12.0% in IVI eyes and 21.1% in control eyes) (P=0.44). There were no cases of resistance to vancomycin, teicoplanin and linezolid. CONCLUSION There was no difference in species of bacteria isolated from cultures, or in the frequency of resistance to antibiotics between eyes that had recurrent IVI followed by moxifloxacin exposure compared with control eyes. However, the number of eyes that had bacterial growth was higher in IVI group than in the control group.
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Affiliation(s)
- Mustafa Ataş
- Department of Ophtalmology, Kayseri Education and Research Hospital, Kayseri 38010, Turkey
| | - Burhan Başkan
- Department of Ophtalmology, Kayseri Education and Research Hospital, Kayseri 38010, Turkey
| | - Ayşe Ozköse
- Department of Ophtalmology, Kayseri Education and Research Hospital, Kayseri 38010, Turkey
| | - Fatma Mutlu Sarıgüzel
- Department of Microbiology, Kayseri Education and Research Hospital, Kayseri 38010, Turkey
| | - Süleyman Demircan
- Department of Ophtalmology, Kayseri Education and Research Hospital, Kayseri 38010, Turkey
| | - Emine Pangal
- Department of Ophtalmology, Kayseri Education and Research Hospital, Kayseri 38010, Turkey
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The ocular surface epithelial barrier and other mechanisms of mucosal protection: from allergy to infectious diseases. Curr Opin Allergy Clin Immunol 2014; 13:563-8. [PMID: 23974687 DOI: 10.1097/aci.0b013e3283645899] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Studies completed in the last decade provide new insights into the role of the epithelial glycocalyx in maintaining ocular surface barrier function. This review summarizes these findings, their relevance to allergic and infectious disease, and highlights the potential benefits of exploiting the modulation of barrier integrity for therapeutic gain. RECENT FINDINGS The molecular components sealing the space between adjacent ocular surface epithelial cells, such as tight junctions, have been extensively characterized, and their contribution to the paracellular barrier established. A second layer of protection - the transcellular barrier - is provided by transmembrane mucins and their O-glycans on the glycocalyx. Cell surface glycans bind carbohydrate-binding proteins to promote formation of complexes that are no longer thought to be a static structure, but, instead, a dynamic system that responds to extrinsic signals and modulates pathogenic responses. Although functioning as a protective mechanism to maintain homeostasis, the glycocalyx also restricts drug targeting of epithelial cells. SUMMARY The traditional model of intercellular junctions protecting the ocular surface epithelia has recently been expanded to include an additional glycan shield that lines apical membranes on the ocular surface. A better understanding of this apical barrier may lead to better management of ocular surface disease.
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Ho S, Pothoulakis C, Koon HW. Antimicrobial peptides and colitis. Curr Pharm Des 2013; 19:40-7. [PMID: 22950497 DOI: 10.2174/13816128130108] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 07/30/2012] [Indexed: 11/22/2022]
Abstract
Antimicrobial peptides (AMPs) are important components of innate immunity. They are often expressed in response to colonic inflammation and infection. Over the last several years, the roles of several antimicrobial peptides have been explored. Gene expression of many AMPs (beta defensin HBD2-4 and cathelicidin) is induced in response to invasion of gut microbes into the mucosal barrier. Some AMPs are expressed in a constitutive manner (alpha defensin HD 5-6 and beta defensin HBD1), while others (defensin and bactericidal/ permeability increasing protein BPI) are particularly associated with Inflammatory Bowel Disease (IBD) due to altered defensin expression or development of autoantibodies against Bactericidal/permeability increasing protein (BPI). Various AMPs have different spectrum and strength of antimicrobial effects. Some may play important roles in modulating the colitis (cathelicidin) while others (lactoferrin, hepcidin) may represent biomarkers of disease activity. The use of AMPs for therapeutic purposes is still at an early stage of development. A few natural AMPs were shown to be able to modulate colitis when delivered intravenously or intracolonically (cathelicidin, elafin and SLPI) in mouse colitis models. New AMPs (synthetic or artificial non-human peptides) are being developed and may represent new therapeutic approaches against colitis. This review discusses the latest research developments in the AMP field with emphasis in innate immunity and pathophysiology of colitis.
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Affiliation(s)
- Samantha Ho
- Inflammatory Bowel Disease Center, Division of Digestive Diseases, David Geffen School of Medicine, The University of California Los Angeles, Los Angeles, CA 90095, USA
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Changes in ocular flora in eyes exposed to ophthalmic antibiotics. Ophthalmology 2013; 120:937-41. [PMID: 23415422 DOI: 10.1016/j.ophtha.2012.11.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 10/27/2012] [Accepted: 11/02/2012] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To determine changes in ocular flora in individuals repeatedly exposed to topical macrolide or fluoroquinolone antibiotics. DESIGN Prospective, controlled, longitudinal study with 1-year follow-up. PARTICIPANTS Forty-eight eyes of 24 patients undergoing serial unilateral intravitreal injection for choroidal neovascularization. METHODS Patients received 4 consecutive monthly unilateral intravitreal injections and were then treated as needed. Each patient was randomized to 1 of 4 antibiotics (azithromycin 1%, gatifloxacin 0.3%, moxifloxacin 0.5%, ofloxacin 0.3%) and used only their assigned antibiotic for 4 days after each injection. Conjunctival cultures of the treated eye and untreated fellow eye (control) were taken at baseline and before each injection. All bacterial isolates were tested for antibiotic susceptibility to 16 different antibiotics using the Kirby-Bauer disc diffusion technique. MAIN OUTCOME MEASURES Changes in bacteria composition of the conjunctiva over time. RESULTS In azithromycin-treated eyes, Staphylococcus epidermidis and Staphylococcus aureus accounted for 54.5% and 18.2% of cultured isolates, respectively, at baseline and 90.9% (P<0.01) and 4.5% (P<0.01), respectively, after azithromycin exposure. In fluoroquinolone-treated eyes, 45.7% and 6.5% of cultured isolates at baseline were S epidermidis and S aureus, respectively, but these percentages increased to 63.4% (P<0.03) and 13% (P = 0.24), respectively, after fluoroquinolone exposure. In contrast, the percentage of gram-negative species decreased from 8.7% at baseline to 1.6% (P<0.05) in fluoroquinolone-treated eyes. The percentage of S epidermidis isolated from azithromycin-treated eyes was significantly greater when compared with fellow control eyes (P<0.01) or fluoroquinolone-treated eyes (P<0.01). CONCLUSIONS The percentage of S epidermidis isolated from the conjunctival surface significantly increases after repeated exposure to azithromycin and to a lesser degree fluoroquinolone antibiotics at the expense of other commensal flora. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Karsten E, Watson SL, Foster LJR. Diversity of microbial species implicated in keratitis: a review. Open Ophthalmol J 2012; 6:110-24. [PMID: 23248737 PMCID: PMC3520035 DOI: 10.2174/1874364101206010110] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 11/06/2012] [Accepted: 11/08/2012] [Indexed: 11/22/2022] Open
Abstract
Background: Microbial keratitis is an infectious disease of the cornea characterised by inflammation and is considered an ophthalmic emergency requiring immediate attention. While a variety of pathogenic microbes associated with microbial keratitis have been identified, a comprehensive review identifying the diversity of species has not been completed. Methods: A search of peer-reviewed publications including case reports and research articles reporting microorganims implicated in keratitis was conducted. Search engines including PubMed, Scopus and Web of Science with years ranging from 1950-2012 were used. Results: 232 different species from 142 genera, representing 80 families were found to be implicated in microbial keratitis. Fungi exhibited the largest diversity with 144 species from 92 genera. In comparison, 77 species of bacteria from 42 genera, 12 species of protozoa from 4 genera and 4 types of virus were identified as the infectious agents. A comparison of their aetiologies shows reports of similarities between genera. Conclusions: The diversity of microbial species implicated in keratitis has not previously been reported and is considerably greater than suggested by incidence studies. Effective treatment is heavily reliant upon correct identification of the responsible microorganisms. Species identification, the risk factors associated with, and pathogenesis of microbial keratitis will allow the development of improved therapies. This review provides a resource for clinicians and researchers to assist in identification and readily source treatment information.
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Affiliation(s)
- Elisabeth Karsten
- Bio/Polymer Research Group, Centre for Advanced Macromolecular Design, School of Biotechnology and Biomolecular Sciences, Faculty of Science
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Üstüntürk M, Zeybek Z. Microbial contamination of contact lens storage cases and domestic tap water of contact lens wearers. Wien Klin Wochenschr 2012; 124 Suppl 3:17-22. [DOI: 10.1007/s00508-012-0251-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 09/10/2012] [Indexed: 10/27/2022]
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Tang A, Balzli CL, Caballero AR, McCormick CC, Taylor SD, O'Callaghan RJ. Staphylococcus aureus infection of the rabbit cornea following topical administration. Curr Eye Res 2012; 37:1075-83. [PMID: 22916736 DOI: 10.3109/02713683.2012.716485] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To determine the ability of diverse S. aureus strains to infect the rabbit cornea following topical inoculation, with special emphasis on a strain of unusual virulence. MATERIALS AND METHODS S. aureus strains (5 × 10(5) colony forming units; CFU) were topically applied onto scarified rabbit corneas or 100 CFU were intrastromally injected into rabbit corneas. Eyes were scored by slit lamp examination (SLE) and corneas were cultured to determine the log CFU. Polymorphonuclear leukocytes (PMN) were quantified by myeloperoxidase assays and corneas underwent histopathological analysis. Hemolysin titers of S. aureus strains were determined and S. aureus interactions with rabbit tears or human corneal epithelial cells were investigated. RESULTS All strains injected into the cornea produced high SLE scores and multi-log increases in CFU. Following topical inoculation, four strains produced low SLE scores with no bacterial replication. One strain (UMCR1) topically infected the cornea, causing high SLE scores, extensive PMN infiltration, and multi-log increases in CFU. Histopathologic analysis demonstrated a PMN influx into the UMCR1-infected cornea, destruction of the corneal epithelium, and severe edema. Strain UMCR1 did not demonstrate a high hemolysin titer or resistance to the bactericidal activity of rabbit tears, but did invade human corneal epithelial cells with relatively high efficiency. CONCLUSIONS One S. aureus strain demonstrated the ability to topically infect the rabbit cornea. This strain was previously found to be unique in its ability to infect the anterior chamber and conjunctiva, suggesting that a key mechanism may be employed to overcome the host defenses of these three ocular sites.
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Affiliation(s)
- Aihua Tang
- Department of Microbiology, University of Mississippi Medical Center, Jackson, MS 39216, USA
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Pahuja P, Arora S, Pawar P. Ocular drug delivery system: a reference to natural polymers. Expert Opin Drug Deliv 2012; 9:837-61. [DOI: 10.1517/17425247.2012.690733] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Abstract
PURPOSE To determine the rate of postinjection endophthalmitis and compare microbial etiology and outcomes in office-based injection-related endophthalmitis versus those acquired after operating room procedures. METHODS Retrospective, observational case series. Consecutive cases of endophthalmitis seen at Retina Consultants of Houston between July 2000 and July 2010 were classified as postsurgical or post-intravitreal injection. Cases secondary to glaucoma surgery, trauma, and endogenous sources were excluded. Main study measures were incidence of endophthalmitis, microbiology results, and visual outcomes. RESULTS In all, 109 cases of endophthalmitis were identified: 88 postsurgical and 21 post-intravitreal injection (3 from clinical trials and 5 from outside ophthalmologists). A total of 33,580 intravitreal injections were performed at Retina Consultants of Houston (endophthalmitis rate = 0.04%, 13 of 33,580; 95% confidence interval, 0.02-0.07%). The most common organisms isolated overall were coagulase-negative staphylococci, while viridans streptococci, a component of human oral flora, was identified over three times more often in the postinjection group compared with the postsurgical group. Compared with all other culture-positive cases related to intravitreal injection, postinjection endophthalmitis secondary to viridans streptococci presented much more rapidly (P < 0.001) and final visual outcomes were much worse (P = 0.004) CONCLUSION Although the overall risk of postinjection endophthalmitis is low, viridans streptococci were identified over three times more frequently in postinjection cases compared with postsurgical cases and these cases had much worse clinical outcomes. The office-based setting for intravitreal injections may lead to a higher risk for infection from oral pathogens.
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Choi HT, Lee DW, Ahn M, Cho NC, You IC. Cultured Organisms and Antibiotic Susceptibility in Infectious Ocular Disease: Results Over a Ten-Year Period. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.7.934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Hyun Tae Choi
- Department of Ophthalmology, Chonbuk National University Hospital and Medical School, Research Institute of Clinical Medicine, Jeonju, Korea
| | - Dong-Wook Lee
- Department of Ophthalmology, Chonbuk National University Hospital and Medical School, Research Institute of Clinical Medicine, Jeonju, Korea
| | - Min Ahn
- Department of Ophthalmology, Chonbuk National University Hospital and Medical School, Research Institute of Clinical Medicine, Jeonju, Korea
| | - Nam Chun Cho
- Department of Ophthalmology, Chonbuk National University Hospital and Medical School, Research Institute of Clinical Medicine, Jeonju, Korea
| | - In Cheon You
- Department of Ophthalmology, Chonbuk National University Hospital and Medical School, Research Institute of Clinical Medicine, Jeonju, Korea
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Grixti A, Sadri M, Edgar J, Datta AV. Common Ocular Surface Disorders in Patients in Intensive Care Units. Ocul Surf 2012; 10:26-42. [DOI: 10.1016/j.jtos.2011.10.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 10/20/2011] [Accepted: 10/20/2011] [Indexed: 10/28/2022]
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Kam KR, Hayes M, Joshi N. Ocular care and complications in the critically ill. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2011. [DOI: 10.1016/j.tacc.2011.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ibrahim HR, Imazato K, Ono H. Human lysozyme possesses novel antimicrobial peptides within its N-terminal domain that target bacterial respiration. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2011; 59:10336-10345. [PMID: 21851100 DOI: 10.1021/jf2020396] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Human milk lysozyme is thought to be a key defense factor in protecting the gastrointestinal tract of newborns against bacterial infection. Recently, evidence was found that pepsin, under conditions relevant to the newborn stomach, cleaves chicken lysozyme (cLZ) at specific loops to generate five antimicrobial peptide motifs. This study explores the antimicrobial role of the corresponding peptides of human lysozyme (hLZ), the actual protein in breast milk. Five peptide motifs of hLZ, one helix-loop-helix (HLH), its two helices (H1 and H2), and two helix-sheet motifs, H2-β-strands 1-2 (H2-S12) or H2-β-strands 1-3 (H2-S13), were synthesized and examined for antimicrobial action. The five peptides of hLZ exhibit microbicidal activity to various degrees against several bacterial strains. The HLH peptide and its N-terminal helix (H1) were significantly the most potent bactericidal to Gram-positive and Gram-negative bacteria and the fungus Candida albicans . Outer and inner membrane permeabilization studies, as well as measurements of transmembrane electrochemical potentials, provided evidence that HLH peptide and its N-terminal helix (H1) kill bacteria by crossing the outer membrane of Gram-negative bacteria via self-promoted uptake and are able to dissipate the membrane potential-dependent respiration of Gram-positive bacteria. This finding is the first to describe that hLZ possesses multiple antimicrobial peptide motifs within its N-terminal domain, providing insight into new classes of antibiotic peptides with potential use in the treatment of infectious diseases.
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Affiliation(s)
- Hisham R Ibrahim
- Department of Biochemistry and Biotechnology, Faculty of Agriculture, Kagoshima University, Kagoshima 890-0065, Japan.
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Dong Q, Brulc JM, Iovieno A, Bates B, Garoutte A, Miller D, Revanna KV, Gao X, Antonopoulos DA, Slepak VZ, Shestopalov VI. Diversity of bacteria at healthy human conjunctiva. Invest Ophthalmol Vis Sci 2011; 52:5408-13. [PMID: 21571682 DOI: 10.1167/iovs.10-6939] [Citation(s) in RCA: 248] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Ocular surface (OS) microbiota contributes to infectious and autoimmune diseases of the eye. Comprehensive analysis of microbial diversity at the OS has been impossible because of the limitations of conventional cultivation techniques. This pilot study aimed to explore true diversity of human OS microbiota using DNA sequencing-based detection and identification of bacteria. METHODS Composition of the bacterial community was characterized using deep sequencing of the 16S rRNA gene amplicon libraries generated from total conjunctival swab DNA. The DNA sequences were classified and the diversity parameters measured using bioinformatics software ESPRIT and MOTHUR and tools available through the Ribosomal Database Project-II (RDP-II). RESULTS Deep sequencing of conjunctival rDNA from four subjects yielded a total of 115,003 quality DNA reads, corresponding to 221 species-level phylotypes per subject. The combined bacterial community classified into 5 phyla and 59 distinct genera. However, 31% of all DNA reads belonged to unclassified or novel bacteria. The intersubject variability of individual OS microbiomes was very significant. Regardless, 12 genera-Pseudomonas, Propionibacterium, Bradyrhizobium, Corynebacterium, Acinetobacter, Brevundimonas, Staphylococci, Aquabacterium, Sphingomonas, Streptococcus, Streptophyta, and Methylobacterium-were ubiquitous among the analyzed cohort and represented the putative "core" of conjunctival microbiota. The other 47 genera accounted for <4% of the classified portion of this microbiome. Unexpectedly, healthy conjunctiva contained many genera that are commonly identified as ocular surface pathogens. CONCLUSIONS The first DNA sequencing-based survey of bacterial population at the conjunctiva have revealed an unexpectedly diverse microbial community. All analyzed samples contained ubiquitous (core) genera that included commensal, environmental, and opportunistic pathogenic bacteria.
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Affiliation(s)
- Qunfeng Dong
- Department of Biological Sciences, University of North Texas, Denton, Texas, USA
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Iwalokun BA, Oluwadun A, Akinsinde KA, Niemogha MT, Nwaokorie FO. Bacteriologic and plasmid analysis of etiologic agents of conjunctivitis in Lagos, Nigeria. J Ophthalmic Inflamm Infect 2011; 1:95-103. [PMID: 21484175 PMCID: PMC3168373 DOI: 10.1007/s12348-011-0024-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Accepted: 03/15/2011] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Conjunctivitis, an inflammation of the conjunctiva, is one of the most common eye problems affecting all age groups in Nigeria. A better understanding of its epidemiology and the antibiotic susceptibility of etiologic bacterial agents is crucial for the initiation of preventive and therapeutic measures. This study determined the distribution and patterns of bacterial infections in Nigerian patients with conjunctivitis. Antibiotic resistance patterns and the plasmid profiles of these pathogens were also investigated. METHODOLOGY A total of 83 consecutive and non-duplicate conjunctival specimens were collected from patients attending eye clinics at three different hospitals in Lagos, Nigeria, between February and September 2010. Specimens were cultured on standard bacteriologic media and the recovered isolates speciated using standard techniques. Susceptibility of pathogens to antibiotics and plasmid DNA extraction were carried out by disk diffusion and alkaline lysis methods. Conjugation experiment was done with rifampicin-resistant Escherichia coli DH5α as the recipient cell. Data were analyzed using the chi-square test. RESULTS All the specimens were culture-positive, yielding a total of 155 bacterial isolates. Gram-positive cocci comprising Staphylococcus aureus (27.7%) and coagulase-negative Staphylococcus sp. (22.6%) accounted for 50.3% (78 of 155) of conjunctivitis cases, followed by Gram-positive bacilli (22.6%), Gram-negative bacilli (21.3%), and Gram-negative cocci (4.5%). Corynebacterium spp. were the most commonly isolated Gram-positive bacilli accounting for 16.1% of conjunctivitis cases. Pseudomonas aeruginosa topped with 9.7% as the most commonly isolated Gram-negative bacilli. Other Gram-negative bacilli in order of their isolations were E. coli (6.5%), Proteus sp. (3.2%), Klebsiella sp. (1.9%), and Enterobacter aerogenes (1.9%). Moraxella spp. were the only Gram-negative cocci isolated, and they accounted for 4.5% of the total conjunctival infections. Further analysis of the complexity of infections showed that 25 specimens elicited mono-infections, while cases of polymicrobial infections caused by two pathogens and three or more pathogens constituted 51.8% and 18.1% of conjunctivitis specimens screened, respectively. The disparity in the percentage contribution of three infection patterns was significant (P < 0.05). Antibiotic susceptibility testing revealed chloramphenicol and ofloxacin as the least and most active antibiotics tested as 99 (63.9%) and 149 (96.1%) of the 155 recovered isolates were sensitive to them. On the whole, the least susceptible pathogen was P. aeruginosa with sensitivities ranging from 20% to 80%, while Moraxella sp. represented the most sensitive pathogen with sensitivities ranging from 71.4% to 100%. Other bacterial isolates also elicited antibiotic sensitivities in the range of 33.3-100%. A total of 101 isolates were screened for plasmids, of which 45 harbored plasmids, yielding a plasmid frequency of 44.6%. Conjugal transfer of resistance to chloramphenicol, ampicillin, and streptomycin was detected in the transconjugants after the mating experiment. The antibiotic resistances were transferred either singly or in combination from six of the seven selected donor strains. The antibiotic resistance pattern transferred by these donor strains was partial and was associated with the transfer of R plasmids of sizes 21.3, 15.2, and 5.0 kb from three of the six transferable strains. The frequencies of transfer of antibiotype or R plasmids to the transconjugants ranged from 1.8 × 10(-7) to 1.4 × 10(-5) transconjugants per donor strain. CONCLUSION Conjunctivitis as an eye problem in Lagos is polymicrobial with infections associated with transferable R plasmids for chloramphenicol, ampicillin, and streptomycin. Continuous surveillance of conjunctivitis in relation to etiology, drug susceptibility, and plasmid transferability in the study area is therefore recommended.
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Affiliation(s)
- Bamidele Abiodun Iwalokun
- Department of Biochemistry Nutrition, Nigerian Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria,
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Shan H, Min D. Prevention of exposure keratopathy in intensive care unit. Int J Ophthalmol 2010; 3:346-8. [PMID: 22553589 DOI: 10.3980/j.issn.2222-3959.2010.04.16] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Accepted: 11/20/2010] [Indexed: 11/02/2022] Open
Abstract
AIM To compare the efficacy for preventing exposure keratopathy of three forms of eye care (artificial tear, moist chamber and polyethylene covers) for intensive care patients. METHODS Eighty-four patients in Intensive Care Unit (ICU) were randomized to three treatment groups, including artificial tears group, moist chambers group and polyethylene film group. Patients of artificial tear group received two drops of carboxymethylcellulose drops to each eye every 2 hours. The moist chambers and the polyethylene were changed every 12 hours or as needed if they became unclean or torn. The corneal fluorescein stains were performed daily. RESULTS No of 28 patients (0%) in the polyethylene group and one of the 27 patients (3.70%) in the moist chamber group had exposure keratopathy, compared to 8 of the 29 patients (27.59%) in the artificial tear group. There were statistical significance between the artificial tear group and the moist chamber group (P=0.02), and the artificial tear group and the polyethylene group (P=0.003). The time on eye care every day of the artificial tear group, the moist chamber group and the polyethylene group was 26.69±2.39 minutes, 35.33±2.63 minutes and 7.48±0.87 minutes, respectively. The eye care of the polyethylene group were statistically more time-save than that of the artificial tear group (P<0.001) and the moist chamber group (P<0.001). CONCLUSION Polyethylene covers are more effective and more time-saving in reducing the incidence of corneal damage in intensive care patients.
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Affiliation(s)
- Hua Shan
- Department of Ophthalmology, the First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
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Bharathi MJ, Ramakrishnan R, Shivakumar C, Meenakshi R, Lionalraj D. Etiology and antibacterial susceptibility pattern of community-acquired bacterial ocular infections in a tertiary eye care hospital in south India. Indian J Ophthalmol 2010; 58:497-507. [PMID: 20952834 PMCID: PMC2993980 DOI: 10.4103/0301-4738.71678] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2009] [Accepted: 04/01/2010] [Indexed: 11/04/2022] Open
Abstract
AIMS To identify the etiology, incidence and prevalence of ocular bacterial infections, and to assess the in vitro susceptibility of these ocular bacterial isolates to commonly used antibiotics. MATERIALS AND METHODS Retrospective analysis of consecutive samples submitted for microbiological evaluation from patients who were clinically diagnosed with ocular infections and were treated at a tertiary eye care referral center in South India between January 2002 and December 2007. RESULTS A total of 4417 ocular samples was submitted for microbiological evaluation, of which 2599 (58.8%) had bacterial growth, 456 (10.3%) had fungal growth, 15 (0.34%) had acanthamoebic growth, 14 (0.32%) had mixed microbial growth and the remaining 1333 (30.2%) had negative growth. The rate of culture-positivity was found to be 88% (P < 0.001) in eyelids' infection, 70% in conjunctival, 69% in lacrimal apparatus, 67.4% in corneal, 51.6% in intraocular tissues, 42.9% in orbital and 39.2% in scleral infections. The most common bacterial species isolated were Staphylococcus aureus (26.69%) followed by Streptococcus pneumoniae (22.14%). Sta. aureus was more prevalent more in eyelid infections (51.22%; P = 0.001) coagulase-negative staphylococci in endophthalmitis (53.1%; P = 0.001), Str. pneumoniae in lacrimal apparatus and corneal infections (64.19%; P = 0.001), Corynebacterium species in blepharitis and conjunctivitis (71%; P = 0.001), Pseudomonas aeruginosa in keratitis and dacryocystitis (66.5%; P = 0.001), Haemophilus species in dacryocystitis and conjunctivitis (66.7%; P = 0.001), Moraxella lacunata in blepharitis (54.17%; P = 0.001) and Moraxella catarrhalis in dacryocystitis (63.83%; P = 0.001). The largest number of gram-positive isolates was susceptible to moxifloxacin (98.7%) and vancomycin (97.9%), and gram-negative isolates to amikacin (93.5%) and gatifloxacin (92.7%). CONCLUSIONS Gram-positive cocci were the most frequent bacteria isolated from ocular infections and were sensitive to moxifloxacin and vancomycin, while gram-negative isolates were more sensitive to amikacin and gatifloxacin.
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Affiliation(s)
- M Jayahar Bharathi
- Department of Microbiology, Aravind Eye Hospital & Postgraduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.
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Multicenter open-label study evaluating the efficacy of azithromycin ophthalmic solution 1% on the signs and symptoms of subjects with blepharitis. Cornea 2010; 29:871-7. [PMID: 20508503 DOI: 10.1097/ico.0b013e3181ca38a0] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate the effect of 4 weeks of treatment with azithromycin ophthalmic solution 1% on eyelid bacterial load, tear cytokines, and signs and symptoms of blepharitis. METHODS Twenty-six subjects (mean age 64.2 years; 65% female; 100% white) with moderate to severe blepharitis received azithromycin ophthalmic solution 1% in the absence of warm compresses or eyelid scrubs for 28 days (twice a day on days 1 and 2 and once a day on days 3-28). Blepharitis signs and symptoms were evaluated at baseline (day 1) and compared with end of treatment (day 29) and 2 follow-up visits (2 and 4 weeks posttreatment). Tear collection and eyelid margin bacterial cultures were performed at baseline and end of treatment. Tear cytokines were measured by a multiplex immunobead assay. RESULTS Four-week azithromycin treatment demonstrated significant decreases from baseline in investigator-rated signs of meibomian gland plugging, eyelid margin redness, palpebral conjunctival redness, and ocular discharge (P < or = 0.002) at day 29, which persisted 4 weeks posttreatment (P < or = 0.006). Subject-reported symptoms of eyelid itching, foreign body sensation/sandiness/grittiness, ocular dryness, ocular burning/pain, and swollen/heavy eyelids also demonstrated significant improvement from baseline (P < 0.001 for all symptoms and time points, except P = 0.037 for ocular dryness at visit 4). Eyelid margin culture exhibited significant decreases in coagulase-negative staphylococci and Corynebacterium xerosis bacteria. Changes in tear cytokine concentrations were not observed. Twelve subjects experienced 19 adverse events, 15 of which were ocular and none of which were serious. CONCLUSIONS Azithromycin provided significant improvement in signs and symptoms of blepharitis after 4 weeks of treatment compared with baseline and persisted in the 4-week follow-up period.
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Spinelli TP, Oliveira-Filho EF, Silva D, Mota R, Sá FB. SHORT COMMUNICATION: Normal aerobic bacterial conjunctival flora in the Crab-eating raccoon (Procyon cancrivorus) and Coati (Nasua nasua) housed in captivity in pernambuco and paraiba (Northeast, Brazil). Vet Ophthalmol 2010; 13 Suppl:134-6. [DOI: 10.1111/j.1463-5224.2009.00728.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
With a lifetime risk of 1% and 700 new cases per year, Non-Hodgkin lymphoma (NHL) is the seventh most frequent type of cancer in Denmark. The incidence of NHL has increased considerably in Western countries over the last decades; consequently, NHL is an increasing clinical problem. Ophthalmic lymphoma, (lymphoma localized in the ocular region, i.e. eyelid, conjunctiva, lacrimal sac, lacrimal gland, orbit, or intraocularly) is relatively uncommon, accounting for 5%-10% of all extranodal lymphomas. It is, however, the most common orbital malignancy. The purpose of this thesis was to review specimens from all Danish patients with a diagnosis of ophthalmic lymphoma during the period 1980-2005, in order to determine the distribution of lymphoma subtypes, and the incidence- and time trends in incidence for ophthalmic lymphoma. Furthermore, an extended analysis of the most frequent subtype, extranodal marginal zone lymphoma (MALT lymphoma), was done to analyse clinical factors and cytogenetic changes with influence on prognosis. A total of 228 Danish patients with a biopsy-reviewed verified diagnosis of ocular adnexal-, orbital-, or intraocular lymphoma were identified. We found that more than 50% of orbital- and ocular adnexal lymphomas were of the MALT lymphoma subtype, whereas diffuse large B-cell lymphoma (DLBCL) predominated intraocularly (Sjo et al. 2008a). Furthermore, lymphoma arising in the lacrimal sac was surprisingly predominantly DLBCL (Sjo et al. 2006). Incidence rates were highly dependent on patient age. There was an increase in incidence rates for the whole population from 1980 to 2005, corresponding to an annual average increase of 3.4% (Sjo et al. 2008a). MALT lymphoma arising in the ocular region was found in 116 patients (Sjo et al. 2008b). One third of patients had a relapse or progression of disease after initial therapy and relapses were frequently found at extra-ocular sites. Overall survival, however, was not significantly poorer for patients with relapse. Furthermore, we found that the frequency of translocations involving the MALT1- and IGH-gene loci is low in ocular region MALT lymphoma (2 of 42, 5%), but may predict increased risk of relapse (Sjo et al. 2008b). In conclusion the incidence of ophthalmic lymphoma is increasing at a high rate in Denmark. Ophthalmic lymphoma consists primarily of MALT lymphoma. The molecular pathogenesis of MALT lymphoma arising in the ocular region rarely involves translocations in the MALT1- and IGH-gene loci.
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Affiliation(s)
- Lene Dissing Sjö
- Eye Pathology Institute, Department of Neuroscience and Pharmacology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
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