Conjunctival Swabs Research Articles

Effect of Liposomal-Lactoferrin-Based Eye Drops on the Conjunctival Microflora of Patients Undergoing Cataract Surgery.

Postoperative endophthalmitis is typically caused by the patient's conjunctival bacterial flora. Povidone iodine solution (5%) is used perioperatively to obtain periocular and ocular antisepsis. However, an adjunctive prophylaxis procedure could further help control the conjunctival microbial load. Considering the increase in antibiotic resistance, a progressive shift toward alternative methods would be desirable. Somilux® eye drops (Alfa Intes, lactoferrin-based eye drops) are medical devices containing liposomal lactoferrin (LF). This study evaluates the effects on conjunctival microflora of LF-based eye drops used in the preoperative phase in patients scheduled for cataract surgery. LF-based eye drops or a vehicle solution (water solution) were instilled 4 times a day starting 3days before cataract surgery. Before the therapy (T0) and at the time of surgery (T1), a conjunctival swab was performed in both eyes and processed to detect microbial growth, microbiological isolation, and species identification. The outcome was the quantification and characterization of the local microbial flora before and after using LF-based or vehicle-based eye drops. Safety of the treatments was also evaluated. 88 eyes of 44 patients (mean [± SD] age 75 [± 12.6] years) were enrolled. At baseline, 54 conjunctival swabs showed only saprophytic flora, 27 showed only potential pathogenic flora, and seven showed both of them. LF-based eye drops reduced the proportion of potentially pathogenic bacteria (36% at T0 vs. 9% at T1, p = 0.008) compared with the vehicle (41% at T0 vs. 55% at T1, p = 0.302) without altering the physiological ocular microbial composition. No adverse events have been reported. Our findings provide a novel contribution to the scientific knowledge on the role of LF in the ophthalmic field, supporting the use of LF-based eye drops as a safe and selective treatment to improve the ocular surface physiological defenses and control the bacterial ocular surface contamination prior to cataract surgery.

The eye wipes with polyhexanide (HexaClean) in preoperative prophylaxis of cataract surgery

Background: Progressively increasing number of eye surgeries forces the development of simple-to-use, effective methods to reduce the risk of postoperative endophthalmitis. We wondered whether the eyelid margin wipes containing 0.1% polyhexamethylene biguanide (PHMB) (HexaClean, VERCO, Poland) influence the reduction of bacterial flora localized in the conjunctival sac and whether it can be used for prophylaxis before the cataract surgery. Material and methods: 95 patients before the cataract surgery were included in the study. The conjunctival swab was collected from patients twice — before using eye wipes and after 5 days of eye wipes usage. The swabs were plated on microbiological enriched media and incubated under aerobic and microaerophilic conditions for 24–48 hours at 35°C ± 2°C. Then the identification of microorganisms was carried out using classic microbiological methods and tests. Results: Bacterial strains were isolated from the conjunctival sac in 84% of patients before using the eye wipes. The largest group of isolated pathogens was Gram-positive cocci, and these were mainly methicillin-sensitive and methicillin-resistant coagulase-negative staphylococci, which accounted for 72% of isolated strains. When the eye wipes were used, the bacterial flora was eliminated from the conjunctival sac in 54% of patients. A reduction in isolated strains and decreased variety of bacteria was observed in another 22% of patients. Conclusion: These results indicate that the application of eyelid wipes with polyhexanide reduces a significant amount of the conjunctival sac microbiota, which may prevent inflammation after cataract surgery.

Detection and Identification of Mycoplasmopsis agassizii in Captive Tortoises with Different Clinical Signs in Italy

Mycoplasmopsis agassizii causes the Upper Respiratory Tract Disease (URTD) in tortoises. The severity of the disease usually ranges from mild to severe respiratory signs. Animals can recover, die, or become asymptomatic carriers and are source of infection for other tortoises. This study describes (i) the clinical history and the results obtained in ten years of diagnostic PCR activity for detecting M. agassizii in different species of captive tortoises in Italy, and (ii) the phylogenetic analysis of the 16S rRNA gene sequences of M. agassizii. A total of 26.0% out of 169 samples resulted positive by PCR and 32 out of 75 (42.7%) animals with symptoms were positive. Sequences ob-tained from the PCR products were conserved, differed from the sequence of the M. agassizii type strain PS6, and were identical to many M. agassizii sequences deposited in databases. In particular, the sequences were identical or very similar to sequences obtained previously from tortoises in It-aly. Since samples collected from different anatomical sites resulted positive, it is suggested that pools of conjunctival, nasal and oral swabs are tested for diagnostic purpose in both symptomatic and asymptomatic animals.

Prevalence of Ocular Chlamydia trachomatis Infection in Amhara Region, Ethiopia, after 8 Years of Trachoma Control Interventions.

Although trachoma mass drug administration (MDA) programs target ocular Chlamydia trachomatis, the global trachoma control program does not monitor infection as a measure of impact but instead relies on monitoring clinical indicators. This study aimed to monitor the prevalence of ocular C. trachomatis among a population-based sample of children ages 1-5 years throughout Amhara, Ethiopia, a region that has received approximately 8 years of annual MDA as part of trachoma control. Between 2014 and 2021, trachoma impact surveys and surveillance surveys were conducted in all 156 districts of Amhara using a multistage cluster randomized methodology. Certified graders assessed individuals ages ≥ 1 year for trachomatous inflammation-follicular (TF), and a random subset of children ages 1-5 years also provided a conjunctival swab. Polymerase chain reaction was used to test for C. trachomatis. A total of 28,410 conjunctival swabs were collected from children ages 1-5 years across Amhara. The regional C. trachomatis infection prevalence was 4.7% (95% uncertainty interval: 4.3-5.1%). Infection was detected in all 10 zones of the region and ranged from 0.2% in Awi Zone to 11.9% in Waghemra Zone. Infection was detected in 17 (26%) districts with a TF prevalence < 10% and in 7 (21%) districts with a TF prevalence < 5%. Through programmatic monitoring of C. trachomatis infection, this study demonstrated that considerable infection remained throughout Amhara despite approximately 8 years of trachoma interventions and that enhanced interventions such as more frequent than annual MDA will be needed if elimination thresholds are to be reached.

Tubulointerstitial nephritis and uveitis syndrome post-COVID-19.

Tubulointerstitial nephritis and uveitis syndrome post-COVID-19.

Molecular analysis of human adenoviral keratoconjunctivitis cases: Results of a 2-year survey

Objective: This study aimed to determine the adenovirus genotypes and their epidemiological features between January 2018 and&#x0D; November 2019, in Istanbul, Turkey.&#x0D; Material and Methods: Conjunctival swab samples were obtained from patients who were clinically diagnosed with keratoconjunctivitis.&#x0D; Samples were screened with an Adeno Detector kit (Rapid Pathogen Screening, RPS Inc., South Williamsport, PA). Nucleic acid&#x0D; extraction and amplification were performed with the ADENOVIRUS ELITe MGB® kit in the ELITe In Genius instrument (Elitech&#x0D; Group, Torino, Italy). For subtyping of the strains, sequencing primers targeted the ‘Hypervariable Region 7’ (HVR-7) of the hexon&#x0D; gene were used. DNA sequence analysis (n:72) was performed with ABI PRISM® 3100 Genetic Analyzer (Applied Biosystems, USA),&#x0D; and subtyping was done by BLAST analysis.&#x0D; Results: The median viral load in the samples (n: 77) was 7 log10 copies/mL (IQR: 4.5-7.4 log10 copies/mL). The clinical finding score&#x0D; was found to be significantly higher in the high viral load group (Adenovirus DNA≥6 Log 10 copies/mL) than in the low viral load&#x0D; group (Adenovirus DNA

Significantly different results in the ocular surface microbiome detected by tear paper and conjunctival swab

BackgroundGreat variation has been observed in the composition of the normal microbiota of the ocular surface, and therefore, in addition to differences in detection techniques, the method of collecting ocular surface specimens has a significant impact on the test results.The goal of this study is to ascertain whether the eye surface microbial communities detected by two different sampling methods are consistent and hence explore the feasibility of using tear test paper instead of conjunctival swabs to collect eye surface samples for microbial investigation.Materials and methodsFrom July 15, 2021, to July 30, 2021, nonirritating tear test strips and conjunctival swabs of both eyes were used in 158 elderly people (> 60 years old) (79 diabetic and 79 nondiabetic adults) in Xinjing Community for high-throughput sequencing of the V3-V4 region of the 16S rRNA gene. The composition of the microbial communities in tear test paper and conjunctival swab samples was analyzed.ResultsThere was no statistically significant difference in Alpha diversity of ocular surface microorganisms represented by tear strip and conjunctival swab in diabetic group (P > 0.05), but there was statistically significant difference in Alpha diversity of ocular surface microorganisms detected by tear strip and conjunctival swab in nondiabetic group (P < 0.05). There were statistically significant differences in Beta diversity of ocular surface microorganisms detected by two sampling methods between diabetic group and nondiabetic group (P < 0.05). There were statistically significant differences in ocular surface microorganisms detected by tear strip method between diabetic group and nondiabetic group (P < 0.05), but there was no statistically significant difference in conjunctival swab method (P > 0.05).ConclusionsTear test paper and conjunctival swabs detect different compositions of microbes through two different techniques of eye surface microbe sampling. Tear test paper cannot completely replace conjunctival swab specimens for the study of microbes related to eye surface diseases.

Ophthalmic manifestations of Covid-19 and Mpox - potentially dangerous complications, and underdiagnosis by researchers and clinicians

Introduction: The Covid-19 pandemic and the increase in monkeypox (Mpox) infections that have been with us for the past two years have forced scientists and doctors to intensify their efforts to understand them. They mainly affect the respiratory, circulatory and immune systems and cause skin lesions. They can lead to death from lung disease, so complications such as ophthalmic ones are not often described in scientific studies, but doctors report that Covid-19 and Mpox patients not infrequently show symptoms such as inflammation, conjunctival congestion, corneal ulceration, swelling of the eye area and others. Aim of the study: The aim of this study was to review scientific articles with a view to presenting the problem of ocular complications following SARS-CoV-2 infection and ways to prevent them. Methods and materials: a literature review was conducted using the PubMed database, using the keywords: “ocular complications”, “ophthalmic complications” “ocular manifestations”, “eye complications”, “monkeypox”, “Mpox”, “Covid-19” “SARS-CoV-2”. Results: PCR studies from conjunctival swabs have confirmed the presence of SARS-COV-2 and MPXV genetic materials in ocular secretions, so they are a reservoir of viruses and pose a risk of further transmission. In the case of Covid-19, the eye can act as a host for infection. Humidification and preventive antibiotic therapy have been shown to prevent bacterial superinfection and avoid serious ocular complications, including loss of vision. Conclusions: Patients with Covid-19 and Mpox should be diagnosed ophthalmologically, as neglect can lead to deterioration and even loss of vision, reducing their quality of life. Eye care treatments and pharmacotherapy prevent future complications. It is also important to use personal protective equipment, take care of hygiene and disinfect equipment used for ophthalmic examinations to prevent the spread of infections to other patients as well as to medical staff.

Detection of SARS-CoV-2 in conjunctival secretion and tears in patients with COVID-19 in a tertiary care centre, South India. .

Aims and objectives: Purpose of this study is to detect the presence of SAR-CoV-2 viral RNA in conjunctival secretions of COVID-19 patients and to compare the RT-PCR positivity rate for SARS-CoV-2 in conjunctival and nasopharyngeal swab. Materials and method: Eighty hospitalised COVID-19 patients whose nasopharyngeal swab tested positive for SARS-CoV-2 by RT-PCR were included in the study. Conjunctival swab was collected from eyes of these patients and sent for detection of SARS-CoV-2 by RT-PCR method. Results: Among the eighty patients, 51 (63.7%) were males and 29 (36.3%) were females. The mean age of the patients was 55.93 ± 16.59. Six patients had ocular manifestations. Eleven (13.75%) patients tested positive on conjunctival swab for SARS-CoV-2 viral RNA and only one of them had ocular manifestations out of the eleven. Conclusion: In our study the presence of SARS-CoV-2 in conjunctival secretions of COVID-19 patients was detected and this was not dependent on presence of ocular manifestations or duration of disease. Though the conjunctival positivity is lower compared to the nasopharyngeal swab sampling, ocular surface and secretions can be a potential route of viral transmission.

Investigating the Role of Adenovirus, Herpes Simplex 1, 2, and Varicella Zoster Virus in Incidence of Conjunctivitis in Tehran, Iran

"Conjunctivitis is one of the most common ocular diseases across the world. In this study, the prevalence of viral Conjunctivitis in patients who were referred to the Eye specialized Hospitals was evaluated. Some of the most important viruses that cause conjunctivitis are Human Adenoviruses (HAdV), Herpes Simplex 1, 2 (HSV-1, HSV-2), and Varicella Zoster Virus (VZV). The clinical diagnosis of eye viral infections is difficult and often controversial. Thus, research to experiment with these causative factors is of pivotal importance. In this cross-sectional study, 200 conjunctival swab samples were collected from symptomatic patients with signs of conjunctivitis who had been referred to two hospitals. After DNA extraction, Multiplex Real-Time PCR was carried out in two separate reactions for each sample. Among 200 collected samples, 34 (17%) and 8 (4%) were positive for Adenovirus and HSV-1 DNA, respectively. There were no HSV-2 and VZV conjunctivitis. No significant correlation was identified between gender and conjunctivitis (P-value: 0.845); however, there was a close correlation between age and conjunctivitis (Pvalue: 0.05). In this study, 66.3% of Adenoviral conjunctivitis occurs in the summer compared to 33.7% in spring. No significant seasonal variation was observed for HSV-1. Our results showed that adenovirus has a key role in causing viral conjunctivitis. "

Use of rapid immunochromatographic tests and PCR for the detection of vaccine viruses (CPV, CDV CAV) in faeces and conjunctival sac swabs of vaccinated dogs

The aim of the study was to determine whether the rapid diagnostic CPV Ag (VetExpert), CDV Ag (VetExpert) and CDV/CAV Ag (VetExpert) tests are able to detect the presence of vaccine viruses in faeces and conjunctival swabs (CDV) collected from dogs vaccinated against distemper, parvovirus and Rubarth’s disease. The tested dogs were administered vaccines once, and then faeces and conjunctival sac swabs were collected from all animals on days: 2, 5, 7, 10, 14, 20, 25 after the vaccination for molecular testing and to perform rapid immunochromatographic tests for the detection of CPV, CDV and CAV antigens. The immunochromatographic tests were not able to detect the presence of any of the tested pathogens during the 25-day observation period in the vaccinated dogs, although CPV was detected in faeces by PCR up to 20 days after vaccination, and CDV and CAV up to 14 days after vaccination. Summing up the results of our own research, it should be stated that rapid immunochromatographic tests are not able to detect CPV, CDV and CAV vaccine viruses in the faeces of animals subjected to vaccination, and in the case of CDV also in the conjunctival swabs, but they are an excellent tool for detecting these pathogens in animals infected with field strains of these viruses and showing clinical symptoms of the diseases.

Sensitivity of PCR in conjunctival swab samples for the diagnosis of canine visceral leishmaniasis: a systematic review and meta-analysis.

To compare the sensitivity of conjunctival swab (CS) and conventional samples (blood, spleen, liver, lymphoid and cutaneous tissue) in the diagnosis of canine visceral leishmaniasis (CVL) by polymerase chain reaction (PCR), a systematic review and meta-analysis was carried out using PubMed, Science Direct, Scopus, Web of Science, VHL/BVS (Virtual Health Library), CAPES, and Scielo databases. Articles published from 2002 to 2022 were considered and the review was updated in Jul 2023. From the total of 371 identified studies, 8 met all the eligibility criteria and were included in this review. Data from 658 CVL-positive dogs and 2541 PCR results were considered. Using a random effect model, data on the sensitivity of the test was compared between intervention (CS samples) and comparison (all the other samples) groups. Overall, the use of CS in the PCR diagnosis of CVL produced 12% higher sensitivity (p=0.013) in the test than all the other samples in combination. The animals' clinical condition did not influence (p>0.142) this overall result. However, when CS was individually compared to each of the conventional samples, the consistent result was observed (p=0.012) only in the CS versus bone marrow comparison. Given their rapid acquisition, minimal invasiveness, and lower cost relative to conventional samples, CS samples present a promising alternative for the molecular diagnosis of CVL.

SARS-CoV-2 and the ocular surface: test accuracy and viral load.

This study aimed to evaluate the pre-sence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in the ocular surface of individuals clinically suspected of coronavirus disease 2019 (COVID-19) and determine the accuracy of different approaches of molecular testing on the ocular surface based on the nasopharyngeal positivity status for COVID-19. A total of 152 individuals with suspected COVID-19 symptoms who simultaneously underwent nasopharyngeal and two different tear film collection techniques for quantitative reverse-transcriptase polymerase chain reaction (RT-qPCR) were included. Tears were collected and randomized: one eye had the filter strip for the Schirmer test and the contralateral eye had conjunctival swab/cytology in the inferior fornix. All patients underwent slit lamp biomicroscopy. The accuracy of various ocular surface collection techniques used for the detection of SARS-CoV-2 RNA was determined. Of the 152 patients enrolled in the study, 86 (56.6%) had COVID-19 confirmed by nasopharyngeal PCR. Both tear film collection techniques detected viral particles: the Schirmer test was positive in 16.3% (14/86) and the conjunctival swab/cytology in 17.4% (15/86), with no statistically significant differences. No positive ocular tests were found among those with negative nasopharyngeal PCR tests. The overall agreement of the ocular tests was 92.7%, and in combination, the sensitivity would increase to 23.2%. The mean cycle threshold values in the nasopharyngeal, Schirmer, and conjunctival swab/cytology tests were 18.2 ± 5.3, 35.6 ± 1.4, and 36.4 ± 3.9, respectively. Compared with the nasopharyngeal test, the Schirmer (p=0.001) and conjunctival swab/cytology (p<0.001) tests had significantly different Ct values. The Schirmer (16.3%) and conjunctival swab (17.4%) tests were comparably capable of detecting SARS-CoV-2 RNA in the ocular surface by RT-PCR accurately based on nasopharyngeal status and demonstrated indistinct sensitivity and specificity. Simultaneous specimen sampling and processing from the nasopharyngeal, Schirmer, and conjunctival swab/cytology tests demonstrated significantly lower viral load in both ocular surface approaches than in the nasopharyngeal test. Ocular manifestations detected by slit lamp biomicroscopy were not associated with ocular RT-PCR positivity.

COVID-19 – OCULAR INVOLVMENT, FINDINGS AND THE RISK OF POTENTIAL TRANSMISSION

The coronavirus disease COVID-19 affects primarily the respiratory system in humans, but it also affects many other organs, including the eyes. The ocular surface is considered as a Sars-CoV-2 gateway; it also plays an important role in its spread through the conjunctival secretions. Conjunctival secretion swabs of 50 people were examined by real-time PCR methodology. All of them were hospitalized due to medium and moderately severe COVID-19 in Lozenetz Hospital Sofia during the period of October-November 2021. The results showed that the severity of clinical findings in the anterior eye segment and subjective complaints did not correspond to the presence of Sars-Cov-2 in conjunctival samples. Nevertheless, eye care specialists need to take notice while working in their ophthalmic practices in order to reduce the risk of virus transmission and diminish SarsCoV-2 infection among visiting patients and health care professionals. An effective program and specific precautions need to be exploited in order to effectively prevent disease spread.

Use of rapid immunochromatographic tests and PCR for the detection of vaccine viruses (CPV, CDV CAV) in faeces and conjunctival sac swabs of vaccinated dogs

The pathologically changed pattern of gonadotropin secretion, responsible for ovulation disorders in fatty ewes, may result from the prolonged increase in leptin concentration as well as from diminution of leptin receptors expression in anterior pituitary cells. Leptin acting peripherally reduces the secretion of insulin – the potent inhibitor of lipolysis. Consequently, an increment in plasma fatty acids level is observed. It was also found that in ewe lambs born to obese sheep carrying twins or triplets, a high plasma level of saturated fatty acids (SFA) is in positive correlation with the delay in puberty. However, the relationship between SFA and gonadotropin secretion from the ovine pituitary cells in pubescent ewe lambs is not clear. Therefore, the aim of the study was to establish the effect of SFA on GnRH-induced secretion of FSH and LH. Pituitary glands were isolated from 7 month old ewe lambs. Pituitary cells were cultured in McCoy 5A medium without GnRH and SFA (negative control), with GnRH only (positive control), with GnRH and 10–9-10–3 M/l of the butyric (C4:0), caprylic (C8:0), lauric (C12:0), palmitic (C16:0) or stearic acid (C18:0). After 2 or 6 h of exposure to SFA followed by 2, 6, 12, 18, 24 or 30 h incubation, the media for LH and FSH analysis were collected. It was found that all used SFA reduce GnRH-induced LH and FSH secretion from pituitary cells in vitro. The most significant (P ≤ 0.05) suppressive effect was observed after 6 h exposure of cells to 10–3 M/l of caprylic acid, 10–4 M/l of palmitic acid and 10–4 M/l of stearic acid compared to the positive control.

Adenoviral Keratoconjunctivitis in Korea: Serotypes and Clinical Characteristics

Purpose: Human adenoviruses are a major cause of epidemic keratoconjunctivitis. Of over 60 genotypes, subgroup D is associated with epidemic keratoconjunctivitis. There are, however, no data regarding the genotypes of conjunctivitis-causing adenoviruses in Korea. The purpose of this study was to determine the types of adenoviruses causing epidemic keratoconjunctivitis and clinical manifestations in Korea.Methods: From November 2016 to September 2017, 20 conjunctival swab specimens were collected from patients who were clinically suspected to have adenoviral keratoconjunctivitis. Nucleic acids were extracted using a QIAamp Viral mini kit and processed on the QIAcube platform. Genotyping targeted for adenovirus capsid hexon genes was performed by using the polymerase chain reaction and sequencing techniques. Patient ages ranged from 18 days to 69 years (median, 37 years).Results: Of 20 collected specimens, 17 (85.0%) were genotyped. Three samples were not amplified with our primer sets. Eleven samples (64.7%) were adenovirus type 8, five (29.4%) were type 37, and one was type 64. All 17 genotyped patients showed conjunctival injections (100%) and follicles (100%), and 12 (84.6%) showed pseudomembrane formation. In case of patients genotyped type 8, most of them showed corneal manifestations and involvement of cornea by type 37 showed filamentary keratitis.Conclusions: This study showed that the polymerase chain reaction and direct sequencing for adenovirus hexon genes of conjunctival swab samples were effective techniques for genotyping the adenoviruses that cause epidemic keratoconjunctivitis. The most common causes of adenoviral keratoconjunctivitis in Korea were adenovirus types 8 and 37 in this period of time. Conjunctival injection, follicle formation, and pseudomembrane formation were the major manifestations of adenovirus types 8 and 37 infections.

1318. Etiology of Infectious Conjunctivitis in Children: A Multi-Center Case-Controlled Study

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.

Ocular surface microbiome in diabetes mellitus

This cross-sectional, age- and gender-matched study included 20 eyes of non-diabetic subjects (non-DM group) and 60 eyes of type 2 diabetes mellitus (DM group). Subgroups of DM were classified by diabetic retinopathy (DR) staging into no DR (DM-no DR), non-proliferative DR (DM-NPDR), proliferative DR (DM-PDR), and by glycemic control (well-controlled DM; HbA1c < 7%, poorly controlled DM; HbA1c ≥ 7%). Conjunctival swabs were performed for ocular surface microbiome analysis using conventional culture and next-generation sequencing analysis (NGS). A higher culture-positive rate was found in DM (15%) than in non-DM group (5%) (p value = 0.437). Pathogenic organisms and antibiotic-resistant strains were detected in the DR groups (DM-NPDR and DM-PDR). The NGS analysis showed that potentially pathogenic bacteria such as Enterobacteriaceae, Neisseriaceae, Escherichia-Shigella, and Pseudomonas predominated in DM, especially in DR. There was dissimilarity in the ocular surface microbiome between DM and non-DM groups. The subgroup analysis showed that the DR group had significantly different microbial community from DM-no DR and non-DM groups (p value < 0.05). The microbial community in the poorly controlled DM was also significantly different from well-controlled DM and non-DM groups (p < 0.001). Using the NGS method, our study is the first to signify the importance of DR and glycemic control status, which affect the changes in the ocular surface microbiome.

Monkeypox-Associated Disciform Keratitis.

The purpose of this study was to describe a case of monkeypox (MPX)-associated disciform keratitis. This is a case report. A 36-year-old male patient presented to the infectious diseases clinic with a 1-week history of disseminated pustular skin lesions, a 4-day history of constitutional symptoms, and redness in the left eye. Testing of blood, 2 skin lesions, and a conjunctival swab confirmed the presence of MPX virus by polymerase chain reaction. On ophthalmologic examination on the 17th day of illness, there was a corneal epithelial ridge that stained with fluorescein with disciform corneal edema and underlying keratic precipitates. The patient was treated with oral tecovirimat 600 mg twice a day for 14 days and topical prednisolone acetate 1% 4 times daily, starting 2 days later. On completion of oral treatment, his corneal findings had resolved except for a small subepithelial scar at which time topical steroids were tapered. MPX may cause disciform keratitis and scarring that closely resembles other ocular viral infections. Clinical trials are urgently needed to define the optimal management of human MPX infections and reduce vision loss.

Fungal blebitis due to Aspergillu ustus. About the first case described in the literature

AbstractPurpose: Blebitis is the infection of the valve created in glaucoma filtering surgery. Only 4 cases have been described that refer to ophthalmic infections caused by A. ustus, the pathogen demonstrated in the cultures in this case.Methods: We present the case of a 73‐year‐old woman with a history of hypertension, dyslipidaemia, hyperuricaemia, hypothyroidism and glaucoma in both eyes under maximum topical treatment, despite which she had elevated intraocular pressure (IOP) and structural progression in the right eye (RE). Trabeculectomy with mitomycin‐C (MMC) was performed in RE. After 36 days, the patient came to the emergency department with a slightly painful red and secretions in RE. Examination revealed a whitish bleb, hyperfiltration, fibrin in the anterior chamber and mild corneal oedema. The vitreous was not found to be involved at any time. A conjunctival swab was taken and treatment was started and the patient was admitted for blebitis 3 days later. Two anterior vitrectomies were necessary, the first with collection of aqueous humour (AH) samples and intravitreal injection of vancomycin, the second, after 3 weeks, with phacoemulsification (leaving the patient in aphakia), collection of AH and vitreous samples and intravitreal injection of voriconazole with the addition of oral fluconazole.Results: Eleven weeks after the first surgery Aspergilus ustus was isolated in vitreous humour samples. After 1 year of follow‐up the patient has visual acuity (VA) of light perception in RE, ptisis bulbi, hypotonia, without pain, discomfort, signs of infection or any other symptoms. Together with her it was decided to perform enucleation.Conclusions: Blebitis is a potentially fatal complication whose risk does not decrease over the years. Being alert to warning signs and symptoms is paramount for early detection and optimal management. To our knowledge this would be the first reported case of A. ustus blebitis.