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Barreto Bellusci H, Gervasoni LF, Peixoto IC, De Oliveira LB, de Oliveira Vieira KC, Toledo ACCG, de Oliveira CBS, Mareco EA, Naga RM, Cataneli VP, Nai GA, Winkelströter LK. Local anesthetics as a tool for Staphylococcus spp. control: a systematic review. Braz J Microbiol 2024; 55:1427-1435. [PMID: 38386261 PMCID: PMC11153409 DOI: 10.1007/s42770-024-01285-2] [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: 04/20/2023] [Accepted: 02/09/2024] [Indexed: 02/23/2024] Open
Abstract
The objective of this work was to carry out a systematic review on the effectiveness of local anesthetics as antimicrobial agents against Staphylococcus spp. Searches were performed in the PubMed, Web of science, Scopus, Embase and Lilacs databases. As inclusion criteria, complete original articles, with in vitro experimental tests with the application of selected anesthetics and bacteria of the genus Staphylococcus spp. This review followed the methodological checklist for writing papers reporting systematic reviews by the PRISMA statement. The risk of bias was assessed according to the JBI critical appraisal checklist. Analysis was performed using an anesthetic-moderated simple linear regression model. This systematic review was registered by the Open Science Framework-OSF ( https://doi.org/10.17605/OSF.IO/C5JM7 ). Initially, 1141 articles were found, of which, after careful selection, 52 articles were analyzed. Lidocaine was the most commonly used anesthetic, being evaluated in 35 of the articles. S. aureus ATCC 25923 was the standard microorganism in 17 articles. The impact of the anesthetic concentration in relation to the antimicrobial effect was evaluated and the results showed that there was no statistically significant difference. (F [5, 12] = 0.688 p = 0.642), even when taking into account the moderator effect of anesthetics individually. Therefore, although the antimicrobial effect of local anesthetics was demonstrated in 82.7% of the studies evaluated, great heterogeneity of the results was found, which made it impossible to carry out a meta-analysis and make recommendations based on the evidence.
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Affiliation(s)
- Henrique Barreto Bellusci
- Mestrado Em Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil
| | - Letícia Franco Gervasoni
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil
| | - Inaiá Calegari Peixoto
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil
| | - Lívia Batista De Oliveira
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil
| | | | - Ana Clara Campagnolo Goncalves Toledo
- Mestrado Em Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil
| | - Crystian Bitencourt Soares de Oliveira
- Mestrado Em Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil
| | - Edson Assunção Mareco
- Programa de Pós-Graduação Em Meio Ambiente E Desenvolvimento Regional, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil
| | - Raju Maddela Naga
- Facultad de Ciencias de La Salud, Universidad Técnica de Manabí, Portoviejo, Ecuador
| | - Valeria Pereira Cataneli
- Mestrado Em Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil
| | - Gisele Alborgheti Nai
- Mestrado Em Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil
- Programa de Pós-Graduação Em Ciência Animal, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil
| | - Lizziane Kretli Winkelströter
- Mestrado Em Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil.
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil.
- Programa de Pós-Graduação Em Ciência Animal, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil.
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Cheng Y, An N, Ishaq HM, Xu J. Ocular microbial dysbiosis and its linkage with infectious keratitis patients in Northwest China: A cross-sectional study. Microb Pathog 2023; 184:106371. [PMID: 37741304 DOI: 10.1016/j.micpath.2023.106371] [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: 06/25/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVES To evaluate the alteration of ocular surface microbiome of patients with infectious keratitis in northwest of China. METHODS The corneal scrapings, eyelid margin and conjunctiva samples were collected from 57 participants, who were divided into bacterial keratitis, fungal keratitis, viral keratitis and control group. The V3-V4 region of bacterial 16S rDNA in each sample was amplified and sequenced on the Illumina HiSeq 2500 sequencing platform, and the differences among different groups were compared bioinformatically. RESULTS Significant alterations of the microbiome were observed in alpha-diversity and beta-diversity analysis between the keratitis groups and the control group (p < 0.05). There was no significant differences between eyelid margin and conjunctiva samples in Alpha-Diversity analysis, but a significant difference between eyelid margin and corneal scraping samples in the keratitis group (p < 0.05, independent t-test). The abundances of Bacillus, Megamonas, Acinetobacter, and Rhodococcu were significantly elevated, while the abundance of Staphylococcus was decreased in the keratitis group compared to the control group. CONCLUSIONS The abundance of the ocular microbiome in patients with bacterial keratitis, fungal keratitis, or viral keratitis was significantly higher than those in the control group. Keratitis patients may have ecological disorder on ocular surface microbiome compared with controls. We believe that the conjunctiva and eyelid margin microbiome combined analysis can more comprehensively reflect the composition and abundance of ocular surface microbiome.
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Affiliation(s)
- Yan Cheng
- Department of Microbiology and Immunology, Key Laboratory of Environment and Genes Related to Diseases of Chinese Ministry of Education, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Na An
- The Fist Affiliated Hospital of Northwestern University, Department of Ophthalmology, The Xi'an Fist Hospital, Shaanxi Institute of Ophthalmology, China
| | - Hafiz Muhammad Ishaq
- Faculty of Veterinary and Animal Sciences, Muhammad Nawaz Shareef University of Agriculture Multan, Pakistan
| | - Jiru Xu
- Department of Microbiology and Immunology, Key Laboratory of Environment and Genes Related to Diseases of Chinese Ministry of Education, School of Medicine, Xi'an Jiaotong University, Xi'an, China.
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Herzog EL, Kreuzer M, Zinkernagel MS, Zysset-Burri DC. Challenges and insights in the exploration of the low abundance human ocular surface microbiome. Front Cell Infect Microbiol 2023; 13:1232147. [PMID: 37727808 PMCID: PMC10505673 DOI: 10.3389/fcimb.2023.1232147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/18/2023] [Indexed: 09/21/2023] Open
Abstract
Purpose The low microbial abundance on the ocular surface results in challenges in the characterization of its microbiome. The purpose of this study was to reveal factors introducing bias in the pipeline from sample collection to data analysis of low-abundant microbiomes. Methods Lower conjunctiva and lower lid swabs were collected from six participants using either standard cotton or flocked nylon swabs. Microbial DNA was isolated with two different kits (with or without prior host DNA depletion and mechanical lysis), followed by whole-metagenome shotgun sequencing with a high sequencing depth set at 60 million reads per sample. The relative microbial compositions were generated using the two different tools MetaPhlan3 and Kraken2. Results The total amount of extracted DNA was increased by using nylon flocked swabs on the lower conjunctiva. In total, 269 microbial species were detected. The most abundant bacterial phyla were Actinobacteria, Firmicutes and Proteobacteria. Depending on the DNA extraction kit and tool used for profiling, the microbial composition and the relative abundance of viruses varied. Conclusion The microbial composition on the ocular surface is not dependent on the swab type, but on the DNA extraction method and profiling tool. These factors have to be considered in further studies about the ocular surface microbiome and other sparsely colonized microbiomes in order to improve data reproducibility. Understanding challenges and biases in the characterization of the ocular surface microbiome may set the basis for microbiome-altering interventions for treatment of ocular surface associated diseases.
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Affiliation(s)
- Elio L. Herzog
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Marco Kreuzer
- Interfaculty Bioinformatics Unit and Swiss Institute of Bioinformatics, University of Bern, Bern, Switzerland
| | - Martin S. Zinkernagel
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Denise C. Zysset-Burri
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
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Al-Hashimi M, Eke T, Kumar C. Comment on: Anesthesia techniques and the risk of complications as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery. J Cataract Refract Surg 2023; 49:1000. [PMID: 37379052 DOI: 10.1097/j.jcrs.0000000000001252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 06/22/2023] [Indexed: 06/29/2023]
Affiliation(s)
- Mustafa Al-Hashimi
- From the Norfolk and Norwich University Hospitals, Norwich, United Kingdom (Al-Hashimi, Eke); Newcastle University, Malaysia (Kumar)
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Singh RB, Das S, Chodosh J, Sharma N, Zegans ME, Kowalski RP, Jhanji V. Paradox of complex diversity: Challenges in the diagnosis and management of bacterial keratitis. Prog Retin Eye Res 2021; 88:101028. [PMID: 34813978 DOI: 10.1016/j.preteyeres.2021.101028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/09/2021] [Accepted: 11/12/2021] [Indexed: 12/12/2022]
Abstract
Bacterial keratitis continues to be one of the leading causes of corneal blindness in the developed as well as the developing world, despite swift progress since the dawn of the "anti-biotic era". Although, we are expeditiously developing our understanding about the different causative organisms and associated pathology leading to keratitis, extensive gaps in knowledge continue to dampen the efforts for early and accurate diagnosis, and management in these patients, resulting in poor clinical outcomes. The ability of the causative bacteria to subdue the therapeutic challenge stems from their large genome encoding complex regulatory networks, variety of unique virulence factors, and rapid secretion of tissue damaging proteases and toxins. In this review article, we have provided an overview of the established classical diagnostic techniques and therapeutics for keratitis caused by various bacteria. We have extensively reported our recent in-roads through novel tools for accurate diagnosis of mono- and poly-bacterial corneal infections. Furthermore, we outlined the recent progress by our group and others in understanding the sub-cellular genomic changes that lead to antibiotic resistance in these organisms. Finally, we discussed in detail, the novel therapies and drug delivery systems in development for the efficacious management of bacterial keratitis.
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Affiliation(s)
- Rohan Bir Singh
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA; Department of Ophthalmology, Leiden University Medical Center, 2333, ZA Leiden, the Netherlands
| | - Sujata Das
- Cornea and Anterior Segment Services, LV Prasad Eye Institute, Bhubaneshwar, India
| | - James Chodosh
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Namrata Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Michael E Zegans
- Department of Ophthalmology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Regis P Kowalski
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; The Charles T Campbell Ophthalmic Microbiology Laboratory, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; The Charles T Campbell Ophthalmic Microbiology Laboratory, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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Diagnostic armamentarium of infectious keratitis: A comprehensive review. Ocul Surf 2021; 23:27-39. [PMID: 34781020 PMCID: PMC8810150 DOI: 10.1016/j.jtos.2021.11.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/05/2021] [Accepted: 11/07/2021] [Indexed: 01/23/2023]
Abstract
Infectious keratitis (IK) represents the leading cause of corneal blindness worldwide, particularly in developing countries. A good outcome of IK is contingent upon timely and accurate diagnosis followed by appropriate interventions. Currently, IK is primarily diagnosed on clinical grounds supplemented by microbiological investigations such as microscopic examination with stains, and culture and sensitivity testing. Although this is the most widely accepted practice adopted in most regions, such an approach is challenged by several factors, including indistinguishable clinical features shared among different causative organisms, polymicrobial infection, long diagnostic turnaround time, and variably low culture positivity rate. In this review, we aim to provide a comprehensive overview of the current diagnostic armamentarium of IK, encompassing conventional microbiological investigations, molecular diagnostics (including polymerase chain reaction and mass spectrometry), and imaging modalities (including anterior segment optical coherence tomography and in vivo confocal microscopy). We also highlight the potential roles of emerging technologies such as next-generation sequencing, artificial intelligence-assisted platforms. and tele-medicine in shaping the future diagnostic landscape of IK.
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Peguda HK, Mahbub SB, Sherpa TD, Subedi D, Habibalahi A, Anwer AG, Gu Z, Willcox MDP, Goldys EM, Carnt NA. The Autofluorescence Patterns of Acanthamoeba castellanii, Pseudomonas aeruginosa and Staphylococcus aureus: Effects of Antibiotics and Tetracaine. Pathogens 2021; 10:pathogens10070894. [PMID: 34358044 PMCID: PMC8308758 DOI: 10.3390/pathogens10070894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 11/28/2022] Open
Abstract
Acanthamoeba Keratitis (AK) can lead to substantial vision loss and morbidity among contact lens wearers. Misdiagnosis or delayed diagnosis is a major factor contributing to poor outcomes of AK. This study aimed to assess the effect of two antibiotics and one anaesthetic drug used in the diagnosis and nonspecific management of keratitis on the autofluorescence patterns of Acanthamoeba and two common bacteria that may also cause keratitis. Acanthamoeba castellanii ATCC 30868, Pseudomonas aeruginosa ATCC 9027, and Staphylococcus aureus ATCC 6538 were grown then diluted in either PBS (bacteria) or ¼ strength Ringer’s solution (Acanthamoeba) to give final concentrations of 0.1 OD at 660 nm or 104 cells/mL. Cells were then treated with ciprofloxacin, tetracycline, tetracaine, or no treatment (naïve). Excitation–emission matrices (EEMs) were collected for each sample with excitation at 270–500 nm with increments in 5 nm steps and emission at 280–700 nm at 2 nm steps using a Fluoromax-4 spectrometer. The data were analysed using MATLAB software to produce smoothed color-coded images of the samples tested. Acanthamoeba exhibited a distinctive fluorescence pattern compared to bacteria. The addition of antibiotics and anaesthetic had variable effects on autofluorescence. Tetracaine altered the fluorescence of all three microorganisms, whereas tetracycline did not show any effect on the fluorescence. Ciprofloxacin produced changes to the fluorescence pattern for the bacteria, but not Acanthamoeba. Fluorescence spectroscopy was able to differentiate Acanthamoeba from P. aeruginosa and S. aureus in vitro. There is a need for further assessment of the fluorescence pattern for different strains of Acanthamoeba and bacteria. Additionally, analysis of the effects of anti-amoebic drugs on the fluorescence pattern of Acanthamoeba and bacteria would be prudent before in vivo testing of the fluorescence diagnostic approach in the animal models.
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Affiliation(s)
- Hari Kumar Peguda
- School of Optometry and Vision Science, University of New South Wales, Sydney 2052, Australia; (T.D.S.); (D.S.); (M.D.P.W.); (N.A.C.)
- Correspondence:
| | - Saabah B. Mahbub
- ARC Centre of Excellence for Nanoscale Biophotonics, Graduate School of Biomedical Engineering, University of New South Wales, Sydney 2052, Australia; (S.B.M.); (A.H.); (A.G.A.); (E.M.G.)
| | - Tashi Doma Sherpa
- School of Optometry and Vision Science, University of New South Wales, Sydney 2052, Australia; (T.D.S.); (D.S.); (M.D.P.W.); (N.A.C.)
| | - Dinesh Subedi
- School of Optometry and Vision Science, University of New South Wales, Sydney 2052, Australia; (T.D.S.); (D.S.); (M.D.P.W.); (N.A.C.)
- School of Biological Sciences, Monash University, Clayton 3800, Australia
| | - Abbas Habibalahi
- ARC Centre of Excellence for Nanoscale Biophotonics, Graduate School of Biomedical Engineering, University of New South Wales, Sydney 2052, Australia; (S.B.M.); (A.H.); (A.G.A.); (E.M.G.)
| | - Ayad G. Anwer
- ARC Centre of Excellence for Nanoscale Biophotonics, Graduate School of Biomedical Engineering, University of New South Wales, Sydney 2052, Australia; (S.B.M.); (A.H.); (A.G.A.); (E.M.G.)
| | - Zi Gu
- School of Chemical Engineering, University of New South Wales, Sydney 2052, Australia;
| | - Mark D. P. Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney 2052, Australia; (T.D.S.); (D.S.); (M.D.P.W.); (N.A.C.)
| | - Ewa M. Goldys
- ARC Centre of Excellence for Nanoscale Biophotonics, Graduate School of Biomedical Engineering, University of New South Wales, Sydney 2052, Australia; (S.B.M.); (A.H.); (A.G.A.); (E.M.G.)
| | - Nicole A. Carnt
- School of Optometry and Vision Science, University of New South Wales, Sydney 2052, Australia; (T.D.S.); (D.S.); (M.D.P.W.); (N.A.C.)
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Ngo J, Khoo P, Watson SL. Improving the Efficiency and the Technique of the Corneal Scrape Procedure via an Evidence Based Instructional Video at a Quaternary Referral Eye Hospital. Curr Eye Res 2020; 45:529-534. [DOI: 10.1080/02713683.2019.1676910] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Jessica Ngo
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Sydney, Australia
- Corneal Unit, Sydney Eye Hospital, Sydney, Australia
| | - Pauline Khoo
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Stephanie L Watson
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Sydney, Australia
- Corneal Unit, Sydney Eye Hospital, Sydney, Australia
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Bouche T, Auzou M, Daurel C, Quintyn J, Join‐Lambert O, Guérin F. In vitro evaluation of the antibacterial activity of Fluorescein ® 0.5% eye drops. Acta Ophthalmol 2020; 98:e260-e261. [PMID: 31359588 DOI: 10.1111/aos.14204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 07/05/2019] [Indexed: 11/24/2022]
Affiliation(s)
- Thibaud Bouche
- UNICAEN CHU de Caen Normandie Department of Ophthalmology Normandy University 14000Caen France
| | - Michel Auzou
- UNICAEN CHU de Caen Normandie Microbiology Laboratory Normandy University 14000Caen France
| | - Claire Daurel
- UNICAEN CHU de Caen Normandie Microbiology Laboratory Normandy University 14000Caen France
| | - Jean‐Claude Quintyn
- UNICAEN CHU de Caen Normandie Department of Ophthalmology Normandy University 14000Caen France
- UNICAEN CHU de Caen Normandie Unité de recherche UMR‐S 1075 INSERM‐UNICAEN Normandy University 14000Caen France
| | - Olivier Join‐Lambert
- UNICAEN CHU de Caen Normandie Microbiology Laboratory Normandy University 14000Caen France
- Groupe de Recherche sur l'Adaptation Microbienne GRAM 2.0, EA2656 Caen France
| | - François Guérin
- UNICAEN CHU de Caen Normandie Microbiology Laboratory Normandy University 14000Caen France
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Fentiman KE, Rankin AJ, Meekins JM, Roush JK. Effects of topical ophthalmic application of 0.5% proparacaine hydrochloride on aerobic bacterial culture results for naturally occurring infected corneal ulcers in dogs. J Am Vet Med Assoc 2018; 253:1140-1145. [DOI: 10.2460/javma.253.9.1140] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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11
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Lin A, Rhee MK, Akpek EK, Amescua G, Farid M, Garcia-Ferrer FJ, Varu DM, Musch DC, Dunn SP, Mah FS. Bacterial Keratitis Preferred Practice Pattern®. Ophthalmology 2018; 126:P1-P55. [PMID: 30366799 DOI: 10.1016/j.ophtha.2018.10.018] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 10/05/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- Amy Lin
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Michelle K Rhee
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Esen K Akpek
- The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | - Guillermo Amescua
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Marjan Farid
- Gavin Herbert Eye Institute, Department of Ophthalmology, University of California, Irvine, California
| | | | | | - David C Musch
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | | | - Francis S Mah
- Departments of Cornea and External Diseases, Scripps Clinic Torrey Pines, La Jolla, California
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Ruiz Caro JM, Cabrejas L, de Hoz MR, Mingo D, Duran SP. Clinical features and microbiological in bacterial keratitis in a tertiary referral hospital. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2017; 92:419-425. [PMID: 28236499 DOI: 10.1016/j.oftal.2017.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 01/05/2017] [Accepted: 01/11/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To describe the clinical features, bacterial agents, and antibiotic sensitivity of bacterial keratitis in the Ophthalmology Department at the University Hospital Fundación Jiménez Díaz (HUFJD) in Madrid. MATERIALS AND METHODS A retrospective observational descriptive study using clinical records and reports of corneal scrapings in patients with bacterial keratitis at the HUFJD conducted between 2009 and 2014. RESULTS In a sample of 160 patients, gram-positive bacteria were the most prevalent with 64.3% (n=103). Coagulase negative staphylococcus (20.6%), Staphylococcus aureus (19.4%), and Pseudomonas aeruginosa (12.5%) were the most frequent bacteria. The most common risk factor was the use of contact lenses, followed by disease of the ocular surface, and previous ocular surgeries. The antibiotics to which the bacteria were most commonly susceptible were gentamicin (n=114), cotrimoxazole (n=107), vancomycin (n=106), and ciprofloxacin (n=97). The antibiotics to which the bacteria were most commonly resistant were ampicillin (n=59) and erythromycin (n=45). CONCLUSIONS In the initial management of bacterial keratitis, the sensitivity and resistance of bacteria to antibiotics should be taken into account. Based on our findings, the use of aminoglycosides, vancomycin and fluoroquinolones is recommended, and, although widely used today, the discontinuation of erythromycin.
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Affiliation(s)
- J M Ruiz Caro
- Departamento de Oftalmología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
| | - L Cabrejas
- Departamento de Oftalmología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - M R de Hoz
- Instituto de Investigación Ramón Castroviejo, Madrid, España
| | - D Mingo
- Departamento de Oftalmología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - S P Duran
- Departamento de Oftalmología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
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Caliot J, Guindolet D, Ducasse A, Andreoletti L, Arndt C. [Diagnostic and therapeutic contribution of microbiological analysis in severe microbial keratitis at Reims University Hospital between 2012 and 2014]. J Fr Ophtalmol 2016; 40:8-16. [PMID: 27989423 DOI: 10.1016/j.jfo.2016.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 08/02/2016] [Accepted: 09/16/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To investigate the contribution of microbial analysis in the diagnosis and management of severe microbial keratitis. MATERIAL AND METHOD This is a monocentric retrospective study at the University Hospital of Reims from January 2012 to December 2014. Corneal scrapings with infectious keratitis were subjected to routine bacterial and fungal culture. PCR was also performed to detect various viral DNA (VZV, CMV, EBV, HSV 1 & 2, adenovirus) and Acanthamoeba sp. DNA. All contact lens cases were analyzed if available. RESULTS One hundred and six patients were hospitalized, including 30 contact lens wearers (28.3%). Sixty-four bacterial cultures were positive (68%). Twenty-five different bacterial species were identified with a majority of gram-positive bacteria (67.92%). Among contact lens wearers, the initial VA was better than non-wearers (P=0.0004) and 37% of bacteria identified (a plurality) were gram positive. Of 11 contact lens case analyzed, in only one case (3.3%) did the result correlate with the corneal culture. Only 9 samples from the 323 viral DNA extractions and real time PCR were positive (2.8%); 7 were HSV1. No prior antiviral therapy had been started. Fungal culture was positive in 2 of the 97 corneal samples taken and 63.6% of the contact lens cases (7/11 cases). Only one of the 40 Acanthamoeba sp. PCR's was positive. CONCLUSION The systematic performance of microbiological investigations is a good diagnostic approach given the polymorphism of clinical presentations of corneal ulcers, which can sometimes be extremely misleading. Culture of contact lens cases appears ineffective for the detection and determination of the causative microorganism. The high incidence of Staphylococcus in bacterial keratitis and the prevalence of infections with gram-positive bacteria in contact lens wearers were noted.
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Affiliation(s)
- J Caliot
- Service d'ophtalmologie, hôpital Robert-Debré, CHU de Reims, rue du Général-Koenig, 51090 Reims, France.
| | - D Guindolet
- Service d'ophtalmologie, fondation ophtalmologique Adolphe-de-Rothschild, 29, rue Manin, 75019 Paris, France
| | - A Ducasse
- Service d'ophtalmologie, hôpital Robert-Debré, CHU de Reims, rue du Général-Koenig, 51090 Reims, France
| | - L Andreoletti
- Laboratoire de virologie médicale et moléculaire, faculté de médecine, 51, avenue Cognac-Jay, 51092 Reims cedex, France
| | - C Arndt
- Service d'ophtalmologie, hôpital Robert-Debré, CHU de Reims, rue du Général-Koenig, 51090 Reims, France
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Endophthalmitis After Intravitreal Injections: Incidence, Presentation, Management, and Visual Outcome. Am J Ophthalmol 2015; 160:17-25.e1. [PMID: 25892127 DOI: 10.1016/j.ajo.2015.04.013] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 04/09/2015] [Accepted: 04/10/2015] [Indexed: 11/23/2022]
Abstract
PURPOSE To report the incidence and characteristics of endophthalmitis after intravitreal injections of anti-vascular endothelial growth factor agents or corticosteroids and to describe the clinical and bacteriologic characteristics, management, and outcome of these eyes with acute endophthalmitis in France. DESIGN Retrospective, nationwide multicenter case series. METHODS From January 2, 2008 to June 30, 2013, a total of 316,576 intravitreal injections from 25 French ophthalmic centers were included. For each center, the number of intravitreal injections was determined using billing codes and the injection protocol was recorded. A registry and hospital records were reviewed to identify patients treated for endophthalmitis after injection during the same time period. The main outcome measures were the incidence of clinical endophthalmitis and visual acuity of endophthalmitis cases. RESULTS During the study period, 65 cases of presumed endophthalmitis were found, giving an overall incidence of 0.021% (2.1 in 10,000 injections) (95% confidence interval [CI], 0.016%-0.026%). The median number of days from injection to presentation was 4 [1-26] days. The most common symptom was vision loss. Bacterial identification was achieved in 43.4%. The most frequent pathogens were gram-positive bacteria (91.3%), including coagulase-negative Staphylococcus in 78.3%. Neither the interval between injection and presentation for endophthalmitis nor the clinical signs differentiated culture-positive from culture-negative cases. In multivariate analysis, the use of a disposable conjunctival mould assist device and the use of prophylaxis with an antibiotic or antiseptic were significantly associated with an increased incidence of endophthalmitis (P = .001). The majority of patients had worse visual acuity after 3 months of follow-up when compared with acuity before endophthalmitis. CONCLUSIONS The incidence of presumed endophthalmitis after intravitreal injections of anti-vascular endothelial growth factors or corticosteroids was low and the prognosis poor. Prevention and management remain challenging. It remains to be determined whether the findings of this study are relevant for other countries using different techniques for intravitreal injections.
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16
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Antibacterial activity of preservative-free topical anesthetic drops in current use in ophthalmology departments. Cornea 2009; 28:58-61. [PMID: 19092407 DOI: 10.1097/ico.0b013e318182ecf9] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM The antibacterial effect of topical anesthetics may lead to false-negative cultures from corneal specimens of bacterial keratitis. This in vitro study compared the antibacterial effect of 3 unpreserved topical anesthetics to indicate the most appropriate agent for corneal scrapes. METHODS Four bacterial strains (Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, and Streptococcus pneumoniae) derived from the most frequently isolated microorganisms from corneal ulcers were cultured from stored control stocks and clinical specimens. These strains were used to determine the minimum inhibitory concentration (MIC) of 3 preservative-free anesthetic eyedrops: proxymetacaine 0.5%, oxybuprocaine 0.4%, and tetracaine 1%. RESULTS There was no inhibition of growth seen with proxymetacaine 0.5% (5000 microg/mL) with any of the organisms except S. epidermidis, which demonstrated an MIC of 2500 microg/mL (equivalent to a dilution of (1/2)). Tetracaine 1% (10,000 microg/mL) produced an MIC ranging between 625 and 1250 microg/mL, inhibiting all 4 strains at the commercially available dilution. Oxybuprocaine 0.4% (4000 microg/mL) resulted to be the second most inhibitory preparation with an MIC ranging between 1000 and 2000 microg/mL. CONCLUSIONS Currently used preservative-free topical anesthetics differ in bacterial growth inhibition. This in vitro study showed that proxymetacaine 0.5% is the least inhibitory on bacterial growth and therefore the most appropriate to be used before corneal scrapes.
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Walker TD. Pharmacological attempts to reduce posterior capsule opacification after cataract surgery - a review. Clin Exp Ophthalmol 2008; 36:883-90. [DOI: 10.1111/j.1442-9071.2009.01921.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cassuto J, Sinclair R, Bonderovic M. Anti-inflammatory properties of local anesthetics and their present and potential clinical implications. Acta Anaesthesiol Scand 2006; 50:265-82. [PMID: 16480459 DOI: 10.1111/j.1399-6576.2006.00936.x] [Citation(s) in RCA: 206] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Development of new local anesthetic agents has been focused on the potency of their nerve-blocking effects, duration of action and safety and has resulted in a substantial number of agents in clinical use. It is well established and well documented that the nerve blocking effects of local anesthetics are secondary to their interaction with the Na+ channels thereby blocking nerve membrane excitability and the generation of action potentials. Accumulating data suggest however that local anesthetics also possess a wide range of anti-inflammatory actions through their effects on cells of the immune system, as well as on other cells, e.g. microorganisms, thrombocytes and erythrocytes. The potent anti-inflammatory properties of local anesthetics, superior in several aspects to traditional anti-inflammatory agents of the NSAID and steroid groups and with fewer side-effects, has prompted clinicians to introduce them in the treatment of various inflammation-related conditions and diseases. They have proved successful in the treatment of burn injuries, interstitial cystitis, ulcerative proctitis, arthritis and herpes simplex infections. The detailed mechanisms of action are not fully understood but seem to involve a reversible interaction with membrane proteins and lipids thus regulating cell metabolic activity, migration, exocytosis and phagocytosis.
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Affiliation(s)
- J Cassuto
- Department of Anesthesiology and Intensive Care and Institution of Surgical Specialties, Sahlgrenska University Hospital, Mölndal, Sweden.
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