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Updated: Jul 12, 2025
Conjunctival Commensal Isolation and Identification in Mice
Published on: May 1, 2021
Pathogen Surveillance for Acute Infectious Conjunctivitis
Edmund Tsui1,2, Ruti Sella3,4, Vivien Tham5,6
1Ocular Inflammatory Disease Center, UCLA Stein Eye Institute, Los Angeles, California.
Importance:
Acute infectious conjunctivitis is a common ocular condition with major public health consequences.
Objective:
To assess regional variations and microbial etiologies of acute infectious conjunctivitis to guide treatment.
Design, Setting, And Participants:
In this cross-sectional study, patients with presumed acute infectious conjunctivitis were enrolled in the study at 5 sites (Honolulu, Hawaii; Los Angeles, San Francisco, and San Diego, California; and Petah-Tikva, Israel) from March 2021 to March 2023. Patients with allergic or toxic conjunctivitis were excluded.
Main Outcomes And Measures:
Pathogens were identified by unbiased RNA deep sequencing.
Results:
In all, 52 patients (mean [range] age, 48 [7-80] years; 31 females [60%]) were enrolled at 5 sites (6 patients from Honolulu, 9 from San Diego, 11 from Los Angeles, 13 from San Francisco, and 13 from Petah-Tikva). RNA deep sequencing detected human adenovirus species D in one-quarter of patients (13 of 52). A wide range of pathogens, including human coronavirus 229E, SARS-CoV-2, and herpes simplex virus type 1, was also identified, as well as several bacteria and fungi. Moreover, 62% (32 of 52) of patients presented with purulent discharge, while only 8% (4 of 52) of patients had confirmed bacterial pathogens.
Conclusion And Relevance:
In this cross-sectional study, pathogens associated with acute infectious conjunctivitis varied between all 5 sites in the US and Israel. Purulent discharge was a common presenting sign in this study, with a low specificity for bacteria-associated conjunctivitis, suggesting that further diagnostic workup may be necessary to inform antibiotic stewardship. Additional research on cost-effectiveness of using RNA deep sequencing is needed to ascertain whether it is better to monitor patients clinically until resolution of disease.
