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Frost HM, Sebastian T, Jenkins TC, Keith A, Kurtz M, Meece JK, Dominguez SR, Savor-Price C. 1318. Etiology of Infectious Conjunctivitis in Children: A Multi-Center Case-Controlled Study. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.1148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
Acute infectious conjunctivitis (AIC) is a common pediatric infection affecting one in eight children annually. The etiology of AIC is poorly understood but important to inform treatment and return to school recommendations. Additionally, the association of bacteria isolated from the conjunctiva with the development of clinical AIC is not well defined. We aimed to determine the bacterial and viral causes of AIC in children.
Methods
Patients age 6 months-18 years with AIC at Denver Health (Denver, CO) and Marshfield Clinic (Marshfield, WI) from 2019-2021 were included. Age-matched healthy and upper respiratory infection (URI) controls without conjunctivitis were enrolled within 30 days of each case. Patients had a conjunctival flocked swab (Eswab®, Copan Diagnostics) obtained. Nucleic acids were extracted using the NucliSENS® easyMAG® system (Quidel, San Diego, CA) per manufacturer’s instructions. Multiplex RT-PCR for S.pneumoniae, H.influenzae, M.catarrhalis, S.aureus , and 11 respiratory viruses were completed using Lyra® (Quidel, San Diego, CA) and AnDiaTec® assay kits (Quidel Germany GmbH, Kornwestheim, Germany, Table). Nucleic acid amplification and detection was completed on the Applied Biosystems® (ABI) 7500 Fast Dx Real-Time PCR Instrument. Odds ratios were computed for each organism.
Results
A total of 78 cases and 71 controls (33 healthy, 38 URI) were included (Table). Bacteria were detected in 59 (75.6%) cases and 36 (50.7%) of controls (OR 14.3; 4.7,33.7). Respiratory viruses were infrequently detected (cases 2, 2.6%; controls 6, 8.5%), including in the pre-pandemic period. Of bacteria detected in cases, H.influenzae was the most common (56.4%) and had the highest association with conjunctivitis (OR 11.8; 4.8, 29.1) followed by M.catarrhalis (35.9% cases, OR 2.5; 1.2, 5.3). S.pneumoniae was detected more often in controls than cases (33.8% v 26.9%).
Conclusion
H.influenzae is likely the most important pathogen associated with AIC in children. Though data have suggested marginal benefit of antibiotic treat for conjunctivitis overall, studies specifically looking at benefit by organism would advance the field. A rapid diagnostic test for H.influenzae and possibly M.catarrhalis could help direct antibiotic treatment to children most likely to benefit.
Disclosures
Samuel R. Dominguez, MD PhD, Biofire DIagnostics: Advisor/Consultant|Biofire DIagnostics: Grant/Research Support|DiaSorin Molecular: Advisor/Consultant|Karius: Advisor/Consultant|Pfizer: Grant/Research Support.
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Affiliation(s)
- Holly M Frost
- Denver Health and Hospital Authority , Denver, Colorado
| | | | | | - Amy Keith
- Denver Health and Hospital Authority , Denver, Colorado
| | - Melanie Kurtz
- Denver Health and Hospital Authority , Denver, Colorado
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Radonovich LJ, Bessesen MT, Cummings DA, Eagan A, Gaydos C, Gibert C, Gorse GJ, Nyquist AC, Reich NG, Rodrigues-Barradas M, Savor-Price C, Shaffer RE, Simberkoff MS, Perl TM. The Respiratory Protection Effectiveness Clinical Trial (ResPECT): a cluster-randomized comparison of respirator and medical mask effectiveness against respiratory infections in healthcare personnel. BMC Infect Dis 2016; 16:243. [PMID: 27255755 PMCID: PMC4890247 DOI: 10.1186/s12879-016-1494-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 02/18/2016] [Indexed: 12/04/2022] Open
Abstract
Background Although N95 filtering facepiece respirators and medical masks are commonly used for protection against respiratory infections in healthcare settings, more clinical evidence is needed to understand the optimal settings and exposure circumstances for healthcare personnel to use these devices. A lack of clinically germane research has led to equivocal, and occasionally conflicting, healthcare respiratory protection recommendations from public health organizations, professional societies, and experts. Methods The Respiratory Protection Effectiveness Clinical Trial (ResPECT) is a prospective comparison of respiratory protective equipment to be conducted at multiple U.S. study sites. Healthcare personnel who work in outpatient settings will be cluster-randomized to wear N95 respirators or medical masks for protection against infections during respiratory virus season. Outcome measures will include laboratory-confirmed viral respiratory infections, acute respiratory illness, and influenza-like illness. Participant exposures to patients, coworkers, and others with symptoms and signs of respiratory infection, both within and beyond the workplace, will be recorded in daily diaries. Adherence to study protocols will be monitored by the study team. Discussion ResPECT is designed to better understand the extent to which N95s and MMs reduce clinical illness among healthcare personnel. A fully successful study would produce clinically relevant results that help clinician-leaders make reasoned decisions about protection of healthcare personnel against occupationally acquired respiratory infections and prevention of spread within healthcare systems. Trial registration The trial is registered at clinicaltrials.gov, number NCT01249625 (11/29/2010).
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Affiliation(s)
- Lewis J Radonovich
- U.S. Department of Veterans Affairs, National Center for Occupational Health and Infection Control, 1601 SW Archer Road, Mailstop 151E, Gainesville, FL, 32608, USA.
| | - Mary T Bessesen
- Veterans Affairs Eastern Colorado Healthcare System, Denver, CO, USA.,University of Colorado School of Medicine, Denver, CO, USA
| | - Derek A Cummings
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,University of Florida, Gainesville, Florida, USA
| | - Aaron Eagan
- U.S. Department of Veterans Affairs, National Center for Occupational Health and Infection Control, 1601 SW Archer Road, Mailstop 151E, Gainesville, FL, 32608, USA
| | | | - Cynthia Gibert
- Veterans Affairs Medical Center and George Washington University School of Medical and Health Sciences, Washington, DC, USA
| | - Geoffrey J Gorse
- Veterans Affairs St. Louis Healthcare System and Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Ann-Christine Nyquist
- Children's Hospital Colorado, Aurora, CO, USA.,University of Colorado School of Medicine, Denver, CO, USA
| | - Nicholas G Reich
- Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst, MA, USA
| | | | - Connie Savor-Price
- Denver Health, Denver, CO, USA.,University of Colorado School of Medicine, Denver, CO, USA
| | - Ronald E Shaffer
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Pittsburgh, PA, USA
| | | | - Trish M Perl
- Johns Hopkins School of Medicine, Baltimore, MD, USA
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