RESUMO
Among surveyed households, the transmission rate of pediatric conjunctivitis was 12%. Rates did not differ when the index child did or did not use an ophthalmic antibiotic (14% vs 11% [P = 0.6]). Transmission rates were lower than for other infections where children are not routinely excluded from school or daycare.
Assuntos
Conjuntivite Bacteriana , Humanos , Criança , Conjuntivite Bacteriana/transmissão , Conjuntivite Bacteriana/tratamento farmacológico , Conjuntivite Bacteriana/microbiologia , Pré-Escolar , Antibacterianos/uso terapêutico , Características da Família , Conjuntivite , Lactente , Feminino , MasculinoRESUMO
This cohort study examines ambulatory care revisits and same-day topical antibiotic prescription in insured patients with acute infectious conjunctivitis.
Assuntos
Antibacterianos , Conjuntivite Bacteriana , Humanos , Antibacterianos/uso terapêutico , Criança , Adolescente , Masculino , Conjuntivite Bacteriana/tratamento farmacológico , Conjuntivite Bacteriana/microbiologia , Feminino , Pré-Escolar , Infecções Oculares Bacterianas/tratamento farmacológico , Infecções Oculares Bacterianas/microbiologia , Lactente , Conjuntivite/tratamento farmacológicoRESUMO
BACKGROUND Parinaud oculoglandular syndrome is a unilateral granulomatous palpebral conjunctivitis associated with preauricular, submandibular, and cervical lymphadenopathies. Several infectious diseases can cause Parinaud oculoglandular syndrome, usually with a conjunctival entry. The most common underlying pathology is cat scratch disease, followed by the oculoglandular form of tularemia. Diagnosis is usually a serious challenge as these infections are themselves rare. On the other hand, Parinaud oculoglandular syndrome may be a rare manifestation of more common disorders (eg, tuberculosis, syphilis, mumps, herpes simplex and Epstein-Barr virus, adenovirus, Rickettsia, Sporothrix, Chlamydia infections). CASE REPORT We present the case of a 66-year-old man with granulomatous conjunctivitis and ipsilateral preauricular, submandibular, and upper cervical lymphadenopathies following a superficial corneal injury. Although the systematic amoxicillin/clavulanic acid and metronidazole antibiotic therapy started immediately at admission, the suppuration of the lymph nodes required surgical drainage. Based on his anamnesis (sheep breeding; a twig scratching his eye 2 days before the initial attendance) and symptoms, a zoonosis, namely the oculoglandular form of tularemia, was suspected, empiric ciprofloxacin therapy was administered, and the patient recovered without sequelae. The Francisella tularensis infection was eventually confirmed by microagglutination serologic assay. CONCLUSIONS If Parinaud oculoglandular syndrome is diagnosed and cat scratch fever as the most common etiology is not likely, other zoonoses, especially the oculoglandular form of tularemia, should be suspected. Serology is the most common laboratory method of diagnosing tularemia. Empiric fluoroquinolone (ciprofloxacin) or aminoglycoside (gentamicin or streptomycin) antibiotic therapy should be started immediately at the slightest suspicion of oculoglandular tularemia.
Assuntos
Francisella tularensis , Tularemia , Humanos , Masculino , Tularemia/diagnóstico , Tularemia/complicações , Tularemia/tratamento farmacológico , Idoso , Francisella tularensis/isolamento & purificação , Conjuntivite Bacteriana/diagnóstico , Conjuntivite Bacteriana/microbiologia , Conjuntivite Bacteriana/tratamento farmacológico , Síndrome , Antibacterianos/uso terapêutico , Transtornos da Motilidade Ocular/etiologia , Transtornos da Motilidade Ocular/diagnóstico , Linfadenopatia/microbiologiaRESUMO
Transmission rates among children with conjunctivitis were low and antibiotic use was not associated with reduced transmission. Policies recommending exclusion from daycare and school for conjunctivitis should be scrutinized as they may not reduce transmission and may increase unnecessary antibiotic use.
Assuntos
Antibacterianos , Conjuntivite Bacteriana , Infecções por Haemophilus , Haemophilus influenzae , Humanos , Antibacterianos/uso terapêutico , Antibacterianos/administração & dosagem , Haemophilus influenzae/efeitos dos fármacos , Infecções por Haemophilus/tratamento farmacológico , Pré-Escolar , Conjuntivite Bacteriana/tratamento farmacológico , Conjuntivite Bacteriana/microbiologia , Lactente , Feminino , Masculino , Soluções Oftálmicas/uso terapêutico , Conjuntivite/tratamento farmacológico , Conjuntivite/microbiologia , Criança , Administração Oftálmica , Resultado do TratamentoRESUMO
Streptococcus pyogenes (group A beta-hemolytic Streptococcus, GABHS) causes a range of human infections, including necrotizing fasciitis and toxic shock syndrome, because it produces exotoxins that damage host cells, facilitate immune evasion, and serve as T cell superantigens. GABHS conjunctivitis is rare. We report a case of membranous conjunctivitis in a 3-year-old child who was treated with a combination of targeted bactericidal antimicrobials, toxin-synthesis inhibition, and amniotic membrane transplantation.
Assuntos
Âmnio , Antibacterianos , Ceratoconjuntivite , Infecções Estreptocócicas , Streptococcus pyogenes , Humanos , Âmnio/transplante , Streptococcus pyogenes/isolamento & purificação , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Pré-Escolar , Antibacterianos/uso terapêutico , Ceratoconjuntivite/microbiologia , Ceratoconjuntivite/tratamento farmacológico , Ceratoconjuntivite/diagnóstico , Ceratoconjuntivite/cirurgia , Terapia Combinada , Infecções Oculares Bacterianas/microbiologia , Infecções Oculares Bacterianas/tratamento farmacológico , Infecções Oculares Bacterianas/diagnóstico , Masculino , Quimioterapia Combinada , Conjuntivite Bacteriana/microbiologia , Conjuntivite Bacteriana/tratamento farmacológico , Conjuntivite Bacteriana/diagnóstico , FemininoRESUMO
IMPORTANCE: Haemophilus influenzae biogroup aegyptius is a human-adapted pathogen and the causative agent of Brazilian purpuric fever (BPF), an invasive disease with high mortality, that sporadically manifests in children previously suffering conjunctivitis. Phase variation is a rapid and reversible switching of gene expression found in many bacterial species, and typically associated with outer-membrane proteins. Phase variation of cytoplasmic DNA methyltransferases has been shown to play important roles in bacterial gene regulation and can act as epigenetic switches, regulating the expression of multiple genes as part of systems called phasevarions (phase-variable regulons). This study characterized two alleles of the ModA phasevarion present in H. influenzae biogroup aegyptius, ModA13, found in non-BPF causing strains and ModA16, unique to BPF causing isolates. Phase variation of ModA13 and ModA16 led to genome-wide changes to DNA methylation resulting in altered protein expression. These changes did not affect serum resistance in H. influenzae biogroup aegyptius strains.
Assuntos
Conjuntivite Bacteriana , Infecções por Haemophilus , Criança , Humanos , Haemophilus influenzae/genética , Variação de Fase , Proteínas de Membrana/genética , Infecções por Haemophilus/microbiologia , Conjuntivite Bacteriana/microbiologiaRESUMO
Neisseria meningitidis represents an uncommon pathogen of acute bacterial conjunctivitis. In this brief report, we describe a case of meningococcal conjunctivitis in an immunocompetent adult male, with a review of the literature. The patient went to the outpatient ophthalmology clinic complaining of severe ocular discomfort, burning, and redness for more than 2 weeks and, at slit lamp examination, he was diagnosed with a mild conjunctivitis. Microbiology cultures of ocular swabs revealed the growth of colonies, as pure culture, identified as N. meningitidis of serogroup B. A diagnosis of primary meningococcal conjunctivitis was made and treatment of patient with intramuscular injections of ceftriaxone in addition to topical moxifloxacin eye drops for 2 weeks led to clinical improvement and, finally, to a complete recovery, in accordance with microbiological findings. Ophthalmologists must be aware of the possibility of primary meningococcal conjunctivitis cases, even uncommon, and the need to treat with systemic antibiotics and their close contacts with adequate antibiotic chemoprophylaxis.
Assuntos
Conjuntivite Bacteriana , Conjuntivite , Infecções Meningocócicas , Neisseria meningitidis , Adulto , Masculino , Humanos , Pessoa de Meia-Idade , Infecções Meningocócicas/diagnóstico , Infecções Meningocócicas/tratamento farmacológico , Infecções Meningocócicas/microbiologia , Conjuntivite Bacteriana/diagnóstico , Conjuntivite Bacteriana/tratamento farmacológico , Conjuntivite Bacteriana/microbiologia , Antibacterianos/uso terapêutico , Conjuntivite/diagnóstico , Conjuntivite/tratamento farmacológico , Conjuntivite/microbiologiaRESUMO
Infectious bovine keratoconjunctivitis (IBK), commonly known as pinkeye, has a marked negative impact on the economy of the cattle industry. Moraxella species, including Mor. bovis and Mor. bovoculi, which have been associated with this disease, colonize clinically healthy eyes as well, suggesting that there are intrinsic changes that may occur to the ocular microbiota or the involvement of additional unrecognized organisms that contribute to IBK. To evaluate this, 104 ocular swabs collected from eyes with IBK or clinically healthy eyes from 16 different cattle herds were subjected to 16 S rRNA gene PCR and next generation sequencing (NGS) analysis. Organisms detected were similar across the herds and there was no difference in the total number of bacterial groups detected among IBK cases and controls. However, the percentages of the different organisms detected varied between the two groups, including Moraxella spp., with more Moraxella spp. in eyes with IBK than controls. Further, using culture and whole genome NGS, a new species of Moraxella (suggested name Mor. oculobovii) was detected from the eyes of cattle from two farms. This strain is non-hemolytic on blood agar, is missing the RTX operon, and is likely a non-pathogenic strain of the bovine ocular microbiome. Alteration of the ocular microbiota composition may have a predisposing role, enhancing bacterial infection and the occurrence of clinical IBK. Future studies are required to evaluate if these changes are permanent or if there is a shift in the microbiome following recovery from the infection and how antibiotics might affect the microbiome.
Assuntos
Doenças dos Bovinos , Conjuntivite Bacteriana , Ceratoconjuntivite Infecciosa , Ceratoconjuntivite , Infecções por Moraxellaceae , Infecções por Mycoplasma , Animais , Bovinos , Sequenciamento de Nucleotídeos em Larga Escala/veterinária , Ceratoconjuntivite Infecciosa/epidemiologia , Ceratoconjuntivite Infecciosa/microbiologia , Ceratoconjuntivite/epidemiologia , Ceratoconjuntivite/veterinária , Ceratoconjuntivite/microbiologia , Conjuntivite Bacteriana/microbiologia , Conjuntivite Bacteriana/veterinária , Moraxella/genética , Infecções por Mycoplasma/veterinária , Infecções por Moraxellaceae/epidemiologia , Infecções por Moraxellaceae/veterinária , Infecções por Moraxellaceae/microbiologia , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/microbiologiaRESUMO
OBJECTIVE: To describe the cytological analysis of conjunctiva from normal camels and camels with bacterial conjunctivitis. ANIMALS STUDIED: This study was conducted on 7 normal camels and 15 camels affected with conjunctivitis. The affected camels had a history of conjunctivitis with signs including chemosis, blepharospasm, frequent blinking, and mild-to-moderate serous, mucoid, or purulent ocular discharge. PROCEDURES: Bacterial swabs were collected from the inferior conjunctival sac of the affected eye without topical anesthetics. Conjunctival smears were obtained from the conjunctival surface for cytological analysis. RESULTS: The cellular analysis of ocular smears revealed a higher percentage of basal cells, neutrophils, eosinophils, and macrophages in camels with conjunctivitis compared with normal camels. In contrast to this, smears from normal camels showed an increased percentage of superficial epithelial cells compared with affected camels. The microbiological assessment of conjunctival swabs collected from affected animals identified a bacterial growth of Staphylococcus aureus., Bacillus sp., Streptococcus sp., Enterococcus faecium., Staphylococcus sp., Corynebacterium sp., Coryne pseudotuberculosis., Saprophytica, Enterobacter cloacae, Escherichia coli, Proteus mirabilis, Proteus vulagaris, and Pseudomonas aeruginosa. CONCLUSIONS: It was observed that bacterial conjunctivitis in camels was associated with increased percentages of basal epithelial cells, neutrophils, eosinophils, and macrophages compared with normal camels, while normal camels showed an increased percentage of superficial epithelial cells compared with affected camels.
Assuntos
Conjuntivite Bacteriana , Conjuntivite , Animais , Camelus , Conjuntivite/veterinária , Conjuntivite/microbiologia , Túnica Conjuntiva/microbiologia , Conjuntivite Bacteriana/microbiologia , Conjuntivite Bacteriana/veterinária , Bactérias , StreptococcusRESUMO
OBJECTIVE: To investigate the association between exposure to topical ophthalmic antibiotics during pregnancy and adverse neonatal outcomes. METHODS: In this retrospective cohort study, we identified pregnant women with hordeola, chalazia, blepharitis, or bacterial conjunctivitis from 2005 to 2018 using the Japanese Medical Data Centre Claims Database. From the eligible women, we extracted women who were dispensed no topical antibiotics during the first trimester (non-antibiotic group), women who were dispensed topical fluoroquinolones alone at least once (fluoroquinolone alone group), and women who were dispensed any single type of antibiotic (single-antibiotic group). We compared the frequency of congenital anomalies (CA), preterm birth (PB), low birth weight (LBW), and the composite outcome of these three between the fluoroquinolone and non-antibiotic groups and between the single-antibiotic and non-antibiotic groups, using propensity score adjustment. RESULTS: A total of 891 eligible women were identified. In the fluoroquinolone (n = 409) and non-antibiotic (n = 309) groups, CA occurred in 6.8% and 6.8%, PB in 2.4% and 3.2%, LBW in 2.9% and 3.2%, and the composite outcome in 10.5% and 11.3%, respectively. Analysis using propensity score adjustment showed no significant difference between the groups in the frequency of CA (adjusted odds ratio, 1.15; 95% confidence interval, 0.61-2.18), PB (0.80; 0.30-2.17), LBW (1.08; 0.45-2.63), or the composite outcome (1.12; 0.67-1.87). Comparison of the single-antibiotic and non-antibiotic groups showed similar results. CONCLUSIONS: Topical ophthalmic antibiotics for hordeola, chalazia, blepharitis, or bacterial conjunctivitis during the first trimester were not associated with increased adverse neonatal outcomes.
Assuntos
Blefarite , Calázio , Conjuntivite Bacteriana , Nascimento Prematuro , Antibacterianos/efeitos adversos , Blefarite/induzido quimicamente , Blefarite/tratamento farmacológico , Calázio/induzido quimicamente , Calázio/tratamento farmacológico , Conjuntivite Bacteriana/induzido quimicamente , Conjuntivite Bacteriana/tratamento farmacológico , Conjuntivite Bacteriana/microbiologia , Feminino , Fluoroquinolonas/efeitos adversos , Humanos , Recém-Nascido , Gravidez , Gestantes , Nascimento Prematuro/induzido quimicamente , Nascimento Prematuro/tratamento farmacológico , Pontuação de Propensão , Estudos RetrospectivosRESUMO
Reactive arthritis is an extremely rare spondyloarthritis that affects the peripheral joints and spine, resulting in common symptoms such as arthritis, urethritis, conjunctivitis, and mucocutaneous lesions. On rare occasions, oral lesions such as circinate erosions on the hard and soft palate, gums, tongue, and cheeks may occur. Reactive arthritis may develop during or after genitourinary or gastrointestinal bacterial infections such as Shigella, Salmonella, Yersinia, and Chlamydia. A 36-year-old man presented with circinate balanitis, urethral discharge, oligoarthralgia, conjunctivitis, lymphadenopathy, pharyngitis, and erythematous lesions on the palate. Culture examination showed presence of Neisseria gonorrhoeae and antibiotic treatment resulted in improvement of conjunctivitis and the lesions on the penis. However, severe oligoarthralgia, palatal erosions that increased in severity and size, and depilated areas on the tongue were observed. The definitive diagnosis was reactive arthritis. The prevalence of sexually transmitted infections is increasing, highlighting the need to increase awareness of associated risks such as reactive arthritis. Moreover, consideration of non-specific oral manifestations in a systemic context may aid in effective diagnosis and treatment, suggesting the need for multidisciplinary teams.
Assuntos
Artrite Reativa/patologia , Adulto , Artrite , Artrite Reativa/tratamento farmacológico , Artrite Reativa/microbiologia , Balanite (Inflamação)/microbiologia , Balanite (Inflamação)/patologia , Conjuntivite Bacteriana/microbiologia , Conjuntivite Bacteriana/patologia , Gonorreia/microbiologia , Humanos , Masculino , Doenças da Boca/microbiologia , Doenças da Boca/patologia , Neisseria gonorrhoeae/isolamento & purificação , Faringite/microbiologia , Faringite/patologia , Articulação Sacroilíaca/patologia , Doenças Bacterianas Sexualmente Transmissíveis/tratamento farmacológico , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Doenças Bacterianas Sexualmente Transmissíveis/patologia , Dor de Ombro , Sexo sem Proteção , Doenças Uretrais/microbiologiaAssuntos
Exantema/etiologia , Mucosite/etiologia , Mycoplasma pneumoniae , Pneumonia por Mycoplasma/complicações , Adulto , Conjuntivite Bacteriana/etiologia , Conjuntivite Bacteriana/microbiologia , Conjuntivite Bacteriana/patologia , Exantema/microbiologia , Exantema/patologia , Humanos , Masculino , Boca/patologia , Mucosite/microbiologia , Mucosite/patologia , Pneumonia por Mycoplasma/patologia , Pele/patologiaRESUMO
Purpose: This study aims to evaluate the effect of coronavirus disease 2019 (COVID-19) on conjunctival flora in patients hospitalized with COVID-19.Methods: This prospective, controlled study was conducted between June 2020 and December 2020. The study group consisted of 45 confirmed COVID-19 patients and 43 control subjects. The collected samples were inoculated into the Thioglycollate broth media without delay. The samples with growth were then passed on eosin methylene blue agar, sabouraud dextrose agar, chocolate agar, and 5% sheep blood agar solid media.Results: The mean age of the COVID-19 patients was 64.24 ± 15.4 years, and the control subjects were 59.72 ± 11.4 years. The culture positivity of conjunctiva samples in COVID-19 patients (95.6%) was statistically significantly higher than control subjects (76.7%) (p = .024). Coagulase-negative staphylococcus and Staphylococcus aureus' positivity was significantly higher in COVID-19 patients than control subjects (p < .05).Conclusion: Patients with COVID-19 demonstrate significantly higher culture positivity on conjunctival flora than the control subjects.
Assuntos
COVID-19/epidemiologia , Túnica Conjuntiva/microbiologia , Conjuntivite Bacteriana/epidemiologia , Infecções Oculares Bacterianas/epidemiologia , SARS-CoV-2 , Infecções Estafilocócicas/diagnóstico , Staphylococcus aureus/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Conjuntivite Bacteriana/diagnóstico , Conjuntivite Bacteriana/microbiologia , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/microbiologia , Feminino , Seguimentos , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Prospectivos , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Turquia/epidemiologia , Adulto JovemRESUMO
Haemophilus influenzae is a predominant pathogen for conjunctivitis, acute otitis media and acute bacterial paranasal sinusitis in children. We undertook this study to investigate the possible association among these diseases. Children younger than 18-year-old with a diagnosis of bacterial conjunctivitis plus acute otitis media and/or acute bacterial paranasal sinusitis during 2009-2018 were included. Sampling for bacterial cultures was obtained from the lower palpebral conjunctiva and/or ear discharge with cotton-tipped swabs. A total of 67 children were recruited and the age was 29.5 (± 22.4) months in average. Fifty-seven children had conjunctivitis-otitis media syndrome and eight of them had a concurrent diagnosis of acute paranasal sinusitis. Ten children had conjunctivitis and acute paranasal sinusitis simultaneously. Clusters in household were observed in 50.7% children. Most common isolates were Haemophilus influenzae (70%), Moraxella catarrhalis (18%), and Staphylococcus aureus (8%). Antibiotic resistance rate of H. influenzae was 80% for ampicillin, 18% for amoxicillin-clavulanate, and 11% for the second or third-generation cephalosporins. Apart from well-known conjunctivitis-otitis media syndrome, acute paranasal sinusitis may also be linked to conjunctivitis with a similar pathogenic process. Simultaneous presence of these infections may guide the choice of empiric antibiotics toward H. influenzae.
Assuntos
Conjuntivite Bacteriana/microbiologia , Infecções por Haemophilus/microbiologia , Haemophilus influenzae/patogenicidade , Otite Média/microbiologia , Sinusite/microbiologia , Doença Aguda , Criança , Pré-Escolar , Resistência Microbiana a Medicamentos , Feminino , Haemophilus influenzae/efeitos dos fármacos , Haemophilus influenzae/isolamento & purificação , Humanos , Lactente , Masculino , Testes de Sensibilidade MicrobianaRESUMO
Importance: Off-label treatment was common for ophthalmia neonatorum because only erythromycin ointment had been approved by the US Food and Drug Administration (FDA) for this indication. Ophthalmia neonatorum was previously considered a different indication from bacterial conjunctivitis in older children and adults because of uncertain similarities in the cause of disease and the treatment course between the 2 populations. Prospective therapeutic clinical studies were required to demonstrate the effectiveness of treatment for ophthalmia neonatorum. Objective: To review the therapeutic clinical trials for patients with bacterial conjunctivitis to evaluate the similarity in the cause of disease and the treatment response between neonates and older children and adults. Design, Setting, and Participants: In this comparative effectiveness research review of pooled data from the most recent 30 bacterial conjunctivitis trials (N = 2018) submitted to the FDA to support the approval of topical ophthalmic solutions for older children and adults, 95% CIs were constructed from clinical cure rates. Cure rates in 3 neonatal randomized clinical trials (N = 392) of patients treated with ophthalmic anti-infective solutions of ciprofloxacin, gatifloxacin, and moxifloxacin were constructed and compared. The baseline ocular swab cultures were analyzed. Main Outcomes and Measures: Cure rates of neonatal trials were compared with the 95% CIs among older children and adults. The bacterial organisms isolated from these 2 populations were compared. Results: The 3 neonatal trials enrolled a total of 392 patients, and the 30 trials of older children and adults enrolled a total of 2018 patients. Neonatal clinical cure rates for moxifloxacin (day 4, 48%), ciprofloxacin (day 4, 49%; day 5, 61%), and gatifloxacin (day 7, 79%) were within the 95% CI for products approved to treat older children and adults with bacterial conjunctivitis. Bacterial organisms were consistent between these 2 populations. Conclusions and Relevance: Comparison of the pooled analysis of these historical trial data suggests similarity in the cause of disease and the treatment response between neonates and older children and adults with bacterial conjunctivitis. Therefore, it was appropriate to extrapolate the effectiveness from older children and adults to neonates to support the approval of therapies for ophthalmia neonatorum. Based on this analysis, ophthalmic solutions of ciprofloxacin, gatifloxacin, and moxifloxacin are now approved for all age groups. This analysis presents an approach of using pooled data from previously underpowered individual trials to establish the similarities in the cause of disease and in treatment response between children and adults, which are the fundamental elements used to evaluate whether extrapolation of effectiveness can be used to support drug approval.
Assuntos
Antibacterianos/administração & dosagem , Conjuntivite Bacteriana/tratamento farmacológico , Aprovação de Drogas , Medicina Baseada em Evidências , Oftalmia Neonatal/tratamento farmacológico , United States Food and Drug Administration , Administração Oftálmica , Fatores Etários , Antibacterianos/efeitos adversos , Pesquisa Comparativa da Efetividade , Conjuntivite Bacteriana/diagnóstico , Conjuntivite Bacteriana/microbiologia , Humanos , Recém-Nascido , Oftalmia Neonatal/diagnóstico , Oftalmia Neonatal/microbiologia , Soluções Oftálmicas , Ensaios Clínicos Controlados Aleatórios como Assunto , Indução de Remissão , Resultado do Tratamento , Estados UnidosRESUMO
The etiologic disease organism responsible for causing mycobacteriosis in avian species is an acid-fast gram-positive bacterium. This bacterium causes granulomatous disease in various internal organs, but in cockatiels (Nymphicus hollandicus) it has been commonly identified within the conjunctival tissues. Twenty-six cases of mycobacterial conjunctivitis in cockatiels were diagnosed through histopathologic assessment of diseased tissue samples, Fite acid-fast staining, and polymerase chain reaction in this retrospective study. Clinicians who saw these cases were contacted, and information was obtained regarding recommended treatment protocols prescribed for the patients, the Mycobacterium species identified, and case outcomes. All patients in this retrospective study had a biopsy performed on the affected conjunctival tissue, and because of the small size of the patients, this excisional biopsy removed the affected tissue in its entirety or significantly debulked the lesion. Of the 26 cases, 10 were lost to follow-up, 4 were euthanatized, 7 died, and 5 were alive at the time this information was submitted for publication.
Assuntos
Doenças das Aves/microbiologia , Cacatuas , Conjuntivite Bacteriana/veterinária , Infecções por Mycobacterium/veterinária , Animais , Conjuntivite Bacteriana/microbiologia , Mycobacterium/classificação , Mycobacterium/isolamento & purificação , Infecções por Mycobacterium/microbiologia , Estudos RetrospectivosRESUMO
BACKGROUND/PURPOSE: To date, studies examining polymicrobial infections in ocular disease have mostly been limited to keratitis or endophthalmitis. We characterized polybacterial infections compared to monobacterial infections in prior clinical studies evaluating besifloxacin ophthalmic suspension 0.6% for the treatment of bacterial conjunctivitis and report on associated microbiological outcomes. METHODS: In this post-hoc analysis, microbiological data for subjects with conjunctivitis due to one or more than one bacterial species in three previous studies (two vehicle-, one active-controlled) of besifloxacin were extracted. Bacterial species identified at baseline were deemed causative if their colony count equaled or exceeded species-specific prespecified threshold criteria. In subjects with polybacterial infections, the fold-increase over threshold was used to rank order the contribution of individual species. Baseline pathogens and their minimum inhibitory concentrations (MICs) for common ophthalmic antibiotics were compared by infection type, as were microbial eradication rates following treatment with besifloxacin. RESULTS: Of 1041 subjects with culture-confirmed conjunctivitis, 17% had polybacterial and 83% had monobacterial conjunctivitis at baseline. In polybacterial compared to monobacterial infections, Haemophilus influenzae and Streptococcus pneumoniae were identified less frequently as the dominant infecting species (P = 0.042 and P<0.001, respectively), whereas Streptococcus mitis/S. mitis group was identified more frequently as dominant (P<0.001). Viral coinfection was also identified more frequently in polybacterial infections (P<0.001). Staphylococcus aureus was the most common coinfecting species in polybacterial infections and the second most common dominant species in such infections. With few exceptions, MICs for individual species were comparable regardless of infection type. Clinical microbial eradication rates with besifloxacin were high regardless of infection type (P≤0.016 vs vehicle at follow-up visits). CONCLUSIONS: Approximately one in five subjects with bacterial conjunctivitis are infected with more than one bacterial species underscoring the need for a broad-spectrum antibiotic for such infections. Besifloxacin treatment resulted in robust eradication rates of these infections comparable to monobacterial infections. TRIAL REGISTRATION: NCT000622908, NCT00347932, NCT00348348.