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Gupta V, Vasesi D, Singhal L, Kaur A, Jain S, Gupta P. A cautionary tale of pseudo- Cryptococcus infection in neonates. Trop Doct 2024:494755241264580. [PMID: 39056354 DOI: 10.1177/00494755241264580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
We report a tale of two cases of neonates, where India Ink preparation of cerebrospinal fluid (CSF) received in glass vials was suggestive of Cryptococcus; however, the absence of correlation and report of cases sequentially from the same unit raised alarm bells. Repeat smears using routine in-house and newly prepared stains were prepared and repeat sampling was collected in a strictly sterile specimen container, which resulted in negative microscopy for repeat samples (uncentrifuged and centrifuged). The source of contamination was found to be non-sterile glass vials used for CSF collection. This report underlines the requisite to maintain an aseptic chain from sample collection to processing, to prevent reporting of pseudo-infections that can upset diagnostic accuracy, especially when the aseptic chain has not been maintained.
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Affiliation(s)
- Varsha Gupta
- Department of Microbiology, GMCH-32, Chandigarh, India
| | | | | | - Amitoj Kaur
- Department of Microbiology, GMCH-32, Chandigarh, India
| | - Suksham Jain
- Department of Neonatology, GMCH-32, Chandigarh, India
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2
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Roquefeuil L, Iskandar K, Roques C, Marchin L, Guittard M, Poupet H, Brandely-Piat ML, Jobard M. Evaluating and Managing the Microbial Contamination of Eye Drops: A Two-Phase Hospital-Based Study. Pharmaceutics 2024; 16:933. [PMID: 39065630 PMCID: PMC11279954 DOI: 10.3390/pharmaceutics16070933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
The microbial contamination of eye drop tips and caps varies between 7.7% and 100%. In seeking patient protection and continuous improvement, the Pharmacy Department in the Sterile Ophthalmological and Oncological Preparations Unit at Cochin Hospital AP-HP, Paris, France, conducted a two-phase study to compare the antimicrobial efficiency and practical use of standard packaging and a marketed eye drop container incorporating a self-decontaminating antimicrobial green technology by Pylote SAS at the tip and cap sites. The first phase was conducted in situ to identify the microbial contaminants of eye drops used in the hospital and community settings. A total of 110 eye drops were included for testing. Staphylococcus species were the most prevalent bacteria. Candida parapsilosis was detected in only one residual content sample and, at the same time, on the cap and tip. The second phase was performed in vitro, according to JIS Z2801. Reductions above one log in Staphylococcus aureus and Pseudomonas aeruginosa counts were noted in Pylote SAS eye drop packaging after 24 h of contact. The practical tests showed satisfactory results. Pylote SAS antimicrobial mineral oxide technology exhibited promising effects that combined effectiveness, safety, and sustainability to protect the patient by preventing infections due to the contamination of eye drop containers.
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Affiliation(s)
- Léa Roquefeuil
- Unité de Préparations Stériles Ophtalmologiques et Oncologiques, GHU AP-HP Centre-Université de Paris Cité—Site Cochin, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; (L.R.); (M.-L.B.-P.); (M.J.)
| | - Katia Iskandar
- Department of Pharmacy, School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon
| | - Christine Roques
- Laboratoire de Génie Chimique, CNRS, INPT, UPS, Faculté de Pharmacie, Université de Toulouse, 31062 Toulouse, France;
- FONDEREPHAR, Faculté de Pharmacie, 31062 Toulouse, France
| | - Loïc Marchin
- Pylote SAS, 22 Avenue de la Mouyssaguèse, 31280 Drémil-Lafage, France; (L.M.); (M.G.)
| | - Mylène Guittard
- Pylote SAS, 22 Avenue de la Mouyssaguèse, 31280 Drémil-Lafage, France; (L.M.); (M.G.)
| | - Hélène Poupet
- Laboratoire de Bactériologie, GHU AP-HP Centre-Université de Paris Cité—Site Cochin, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France;
| | - Marie-Laure Brandely-Piat
- Unité de Préparations Stériles Ophtalmologiques et Oncologiques, GHU AP-HP Centre-Université de Paris Cité—Site Cochin, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; (L.R.); (M.-L.B.-P.); (M.J.)
| | - Marion Jobard
- Unité de Préparations Stériles Ophtalmologiques et Oncologiques, GHU AP-HP Centre-Université de Paris Cité—Site Cochin, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; (L.R.); (M.-L.B.-P.); (M.J.)
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3
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Latham SG, Williams RL, Grover LM, Rauz S. Achieving net-zero in the dry eye disease care pathway. Eye (Lond) 2024; 38:829-840. [PMID: 37957294 DOI: 10.1038/s41433-023-02814-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 09/27/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Climate change is a threat to human health and wellbeing across the world. In recent years, there has been a surge in awareness of this crisis, leading to many countries and organisations setting "net-zero" targets. This entails minimising carbon emissions and neutralising remaining emissions by removing carbon from the atmosphere. At the 2022 United Nations Climate Change Conference (COP27), commitments to transition away from fossil fuels and augment climate targets were underwhelming. It is therefore imperative for public and private sector organisations to demonstrate successful implementation of net-zero and set a precedent for the global political consensus. As a top 10 world employer, the United Kingdom National Health Service (NHS) has pledged to reach net-zero by 2045. The NHS has already taken positive steps forward, but its scale and complexity as a health system means stakeholders in each of its services must highlight the specifications for further progress. Dry eye disease is a chronic illness with an estimated global prevalence of 29.5% and an environmentally damaging care pathway. Moreover, environmental damage is a known aggravator of dry eye disease. Worldwide management of this illness generates copious amounts of non-recyclable waste, utilises inefficient supply chains and involves recurrent follow-up appointments and prescriptions. By mapping the dry eye disease care pathway to environmental impact, in this review we will highlight seven key areas in which reduced emissions and pollution could be targeted. Examining these approaches for improved environmental sustainability is critical in driving the transformation needed to preserve our health and wellbeing.
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Affiliation(s)
- Samuel G Latham
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK
| | - Richard L Williams
- School of Chemical Engineering, College of Engineering and Physical Sciences, University of Birmingham, Birmingham, UK
- Healthcare Technologies Institute, University of Birmingham, Birmingham, UK
| | - Liam M Grover
- School of Chemical Engineering, College of Engineering and Physical Sciences, University of Birmingham, Birmingham, UK
- Healthcare Technologies Institute, University of Birmingham, Birmingham, UK
| | - Saaeha Rauz
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK.
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Jokubaite M, Marksa M, Ramanauskiene K. Application of Poloxamer for In Situ Eye Drop Modeling by Enrichment with Propolis and Balsam Poplar Buds Phenolic Compounds. Gels 2024; 10:161. [PMID: 38534579 DOI: 10.3390/gels10030161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/11/2024] [Accepted: 02/19/2024] [Indexed: 03/28/2024] Open
Abstract
In situ poloxamer-based gels are increasingly being explored as ocular drug delivery carriers to extend the release of active substances, thereby enhancing bioavailability. The objective of this study was to develop thermally stable in situ gels incorporating balsam poplar bud extract, propolis extract, and p-coumaric acid solution and to evaluate the physicochemical parameters of these gelified eye drops. This research assessed the compatibility of poloxamer-based eye drops with active components, their physicochemical properties, stability post-sterilization and during storage, and the release profiles of the active compounds. Fifteen eye drop formulations were prepared and categorized into three groups based on active components. One of the active components was propolis extract. As an alternative to propolis, eye drops containing the plant precursor, balsam poplar bud extract, were developed. The third group's active component was p-coumaric acid, a dominant phenolic acid in propolis and balsam poplar bud extracts. The study reported phenolic contents of 76.63 CAE mg/g for propolis and 83.25 CAE mg/g for balsam poplar bud aqueous extracts, with balsam poplar bud extracts showing higher SPF values (14.0) compared to propolis (12.7), while p-coumaric acid solution exhibited the highest SPF values (25.5). All eye drops were transparent, with pH values meeting the requirements for ocular drops. Formulations containing 8-10% poloxamer 407 met the criteria for in situ gels. All formulations remained stable for 90 days. Conclusion: The study results indicate that the formulated gels possess suitable physicochemical properties, are resistant to applied autoclaving conditions, and exhibit an extended release of active compounds with an increase in poloxamer content.
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Affiliation(s)
- Monika Jokubaite
- Department of Drug Chemistry, Faculty of Pharmacy, Lithuanian University of Health Sciences, Sukileliai Avenue 13, LT-50162 Kaunas, Lithuania
| | - Mindaugas Marksa
- Department of Analytical & Toxicological Chemistry, Faculty of Pharmacy, Lithuanian University of Health Sciences, Sukileliai Avenue 13, LT-50162 Kaunas, Lithuania
| | - Kristina Ramanauskiene
- Department of Clinical Pharmacy, Faculty of Pharmacy, Lithuanian University of Health Sciences, Sukileliai Avenue 13, LT-50162 Kaunas, Lithuania
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Ye Y, He J, Wang H, Li W, Wang Q, Luo C, Tang X, Chen X, Jin X, Yao K, Zhou M. Cell Wall Destruction and Internal Cascade Synergistic Antifungal Strategy for Fungal Keratitis. ACS NANO 2022; 16:18729-18745. [PMID: 36278973 DOI: 10.1021/acsnano.2c07444] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Fungal keratitis is one of the most common blindness-causing diseases, but clinical antifungal treatment remains a challenge. The fungal cell wall and biofilm matrix which severely confine the drug preparation are the critical obstructive factors to therapeutic effects. Herein, we report ethylenediaminetetraacetic acid (EDTA) modified AgCu2O nanoparticles (AgCuE NPs) to disrupt the cell wall and then eradicate C. albicans through the internal cascade synergistic effects of ion-released chemotherapy, chemodynamic therapy, photodynamic therapy, and mild photothermal therapy. AgCuE NPs exhibited excellent antifungal activity both in preventing biofilm formation and in destroying mature biofilms. Furthermore, AgCuE NP based gel formulations were topically applied to kill fungi, reduce inflammation, and promote wound healing, using optical coherence tomography and photoacoustic imaging to monitor nanogel retention and therapeutic effects on the infected murine cornea model. The AgCuE NP gel showed good biosafety and no obvious ophthalmic and systemic side effects. This study suggests that the AgCuE NP gel is an effective and safe antifungal strategy for fungal keratitis with a favorable prognosis and potential for clinical translation.
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Affiliation(s)
- Yang Ye
- Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, People's Republic of China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, 310009, People's Republic of China
| | - Jian He
- Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, People's Republic of China
- Institute of Translational Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China
| | - Hanle Wang
- Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, People's Republic of China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, 310009, People's Republic of China
| | - Wenbo Li
- Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, People's Republic of China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, 310009, People's Republic of China
| | - Qingya Wang
- Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, People's Republic of China
- Institute of Translational Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China
| | - Chenqi Luo
- Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, People's Republic of China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, 310009, People's Republic of China
| | - Xiajing Tang
- Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, People's Republic of China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, 310009, People's Republic of China
| | - Xiaoyuan Chen
- Departments of Diagnostic Radiology, Surgery, Chemical and Biomolecular Engineering, and Biomedical Engineering, Yong Loo Lin School of Medicine and College of Design and Engineering, National University of Singapore, Singapore 119074, Singapore
- Clinical Imaging Research Centre, Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
- Nanomedicine Translational Research Program, NUS Center for Nanomedicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Institute of Molecular and Cell Biology, Agency for Science, Technology, and Research (A*STAR), 61 Biopolis Drive, Proteos, Singapore 138673, Singapore
| | - Xiuming Jin
- Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, People's Republic of China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, 310009, People's Republic of China
| | - Ke Yao
- Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, People's Republic of China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, 310009, People's Republic of China
| | - Min Zhou
- Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, People's Republic of China
- Institute of Translational Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China
- Research Center for Life Science and Human Health, Binjiang Institute of Zhejiang University, Hangzhou 310053, People's Republic of China
- State Key Laboratory of Modern Optical Instrumentations, Zhejiang University, Hangzhou 310058, People's Republic of China
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Iskandar K, Marchin L, Kodjikian L, Rocher M, Roques C. Highlighting the Microbial Contamination of the Dropper Tip and Cap of In-Use Eye Drops, the Associated Contributory Factors, and the Risk of Infection: A Past-30-Years Literature Review. Pharmaceutics 2022; 14:pharmaceutics14102176. [PMID: 36297611 PMCID: PMC9611205 DOI: 10.3390/pharmaceutics14102176] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022] Open
Abstract
The sterility of eye drop content is a primary concern from manufacturing until opening, as well as during handling by end users, while microbial contamination of the dropper tip and cap are often disregarded. The contamination of these sites during drug administration represents a risk of microbial transmission and ocular infection. In this review, we aim to assess microbial contamination of the dropper tip and cap of in-use eye drops, the associated contributory factors, and the risk of infection. We conducted a literature search of the MEDLINE, PubMed, and Cochrane Central databases. A total of 31 out of 1503 studies were selected. All the studies conducted in different settings that documented microbiologically contaminated in-use eye drops were included. Our review showed that microbial contamination of the dropper tip and cap of in-use eye drops ranged from 7.7 to 100% of the total contaminated tested samples. Documented contributory factors were conflicting across the literature. Studies investigating the association between eye infection and microbial contamination of the dropper tip and cap were scarce. New technologies offer a promising potential for securing the long-term sterility of eye drop content, tips, and caps, which could benefit from more research and well-defined study protocols under real-life scenarios.
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Affiliation(s)
- Katia Iskandar
- Département des Sciences Pharmaceutiques, Faculté de Pharmacie, Université Libanaise, Beirut 1500, Lebanon
- INSPECT-LB—Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban, Beirut 1202, Lebanon
- Correspondence:
| | - Loïc Marchin
- Pylote SAS, 22 Avenue de la Mouyssaguèse, Dremil-Lafage, 31280 Toulouse, France
| | - Laurent Kodjikian
- Service d’Ophtalmologie, CHU de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
- Département d’Ophtalmologie, Université de Lyon 1, UMR-CNRS 5510, Matéis, INSA, Villeurbanne, 69100 Lyon, France
| | - Maxime Rocher
- Department of Ophthalmology, Limoges University Hospital, 87000 Limoges, France
- Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire Limoges, Université de Limoges, RESINFIT, 87000 Limoges, France
| | - Christine Roques
- Laboratoire de Génie Chimique, Université de Toulouse, CNRS, INPT, UPS, Faculté de Pharmacie, 31062 Toulouse, France
- FONDEREPHAR, Faculté de Pharmacie, 31062 Toulouse, France
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