@article {1396, title = {Human Conjunctival Transcriptome in Acanthamoeba Keratitis: An Exploratory Study.}, journal = {Cornea}, year = {2024}, month = {2024 May 21}, abstract = {

PURPOSE: The purpose of this study was to identify conjunctival transcriptome differences in patients with Acanthamoeba keratitis compared with keratitis with no known associated pathogen.

METHODS: The host conjunctival transcriptome of 9 patients with Acanthamoeba keratitis (AK) is compared with the host conjunctival transcriptome of 13 patients with pathogen-free keratitis. Culture and/or confocal confirmed Acanthamoeba in 8 of 9 participants with AK who underwent metagenomic RNA sequencing as the likely pathogen. Cultures were negative in all 13 cases where metagenomic RNA sequencing did not identify a pathogen.

RESULTS: Transcriptome analysis identified 36 genes differently expressed between patients with AK and patients with presumed sterile, or pathogen-free, keratitis. Gene enrichment analysis revealed that some of these genes participate in several biologic pathways important for cellular signaling, ion transport and homeostasis, glucose transport, and mitochondrial metabolism. Notable relatively differentially expressed genes with potential relevance to Acanthamoeba infection included CPS1, SLC35B4, STEAP2, ATP2B2, NMNAT3, and AKAP12.

CONCLUSIONS: This research suggests that the local transcriptome in Acanthamoeba keratitis may be sufficiently robust to be detected in the conjunctiva and that corneas infected with Acanthamoeba may be distinguished from the inflamed cornea where no pathogen was identified. Given the low sensitivity for corneal cultures, identification of differentially expressed genes may serve as a suggestive transcriptional signature allowing for a complementary diagnostic technique to identify this blinding parasite. Knowledge of differentially expressed genes may also direct investigation of disease pathophysiology and suggest novel pathways for therapeutic targets.

}, issn = {1536-4798}, doi = {10.1097/ICO.0000000000003545}, author = {Seitzman, Gerami D and Keenan, Jeremy D and Lietman, Thomas M and Ruder, Kevin and Zhong, Lina and Chen, Cindi and Liu, YuHeng and Yu, Danny and Abraham, Thomas and Hinterwirth, Armin and Doan, Thuy} } @article {1271, title = {Apollo Rising: Acute Conjunctivitis Outbreak in India, 2022}, journal = {Cornea Open}, year = {2023}, month = {08/2023}, abstract = {

Purpose: The purpose of this study was to identify pathogens associated with the 2022 conjunctivitis outbreak in Tamil Nadu, India. Methods: This prospective study was conducted in November 2022. Patients with presumed acute infectious conjunctivitis presenting to the Aravind Eye Clinic in Madurai, India, were eligible. Anterior nares and conjunctival samples from participants were obtained and processed for metagenomic RNA deep sequencing (RNA-seq). Results: Samples from 29 patients were sequenced. A pathogen was identified in 28/29 (97\%) patients. Coxsackie virus A24v, a highly infectious RNA virus, was the predominant pathogen and detected in 23/29 patients. Human adenovirus D (HAdV-D), a DNA virus commonly associated with conjunctivitis outbreaks, was detected in the remaining patients (5/29). Hemorrhagic conjunctiva was documented in both HAdV-D and Coxsackie virus A24v affected patients but was not the predominant clinical presentation. Phylogenetic analysis of Coxsackie virus A24v revealed a recent divergence from the 2015 outbreak. Conclusions: Coxsackie virus A24v and HAdV-D were cocirculating during the 2022 conjunctivitis outbreak in Tamil Nadu, India. Clinical findings were similar between patients with HAdV-D and Coxsackie virus A24v{\textendash}associated conjunctivitis. As high-throughput sequencing technologies become more readily available and cost-effective, unbiased pathogen surveillance may prove useful for outbreak surveillance and control.

}, issn = {2833-6992}, author = {Prajna, Namperumalsamy Venkatesh and Prajna, Lalitha and Teja, Vishnu and Gunasekaran, Ramesh and Ruder, Kevin and Zhong, Lina and Yu, Danny and Liu, David and Abraham, Thomas and Ao, Wendy and Deiner, Michael and Hinterwirth, Armin and Seitzman, Gerami D. and Doan, Thuy and Lietman, Thomas M. and on behalf of the, Scorpio Study Group} } @article {1351, title = {Comprehensive Profile of Pathogens and Antimicrobial Resistance in Conjunctivitis Cases from Niger.}, journal = {Am J Trop Med Hyg}, volume = {109}, year = {2023}, month = {2023 Dec 06}, pages = {1333-1338}, abstract = {

Infectious conjunctivitis outbreaks remain a public health burden. This study focuses on the pathogen and antimicrobial resistance (AMR) profiles identified in Niger. Sixty-two patients with acute infectious conjunctivitis who presented to health posts were enrolled from December 2021 to May 2022. Nasal and conjunctival swabs were obtained from each patient. Unbiased RNA deep sequencing (RNA-seq) was used to identify associated pathogens. A pathogen was identified in 39 patients (63\%; 95\% CI, 50-74). Of those, an RNA virus was detected in 23 patients (59\%; 95\% CI, 43-73). RNA viruses were diverse and included human coronaviruses (HCoVs): SARS-CoV-2, HCoV-229E, HCoV-HKU1, and HCoV-OC43. A DNA virus was identified in 11 patients (28\%; 95\% CI, 17-44). Of those, four patients had a coinfection with an RNA virus and two patients had a coinfection with both an RNA virus and a bacterium. DNA viruses were predominantly human herpesvirus (cytomegalovirus, Epstein-Barr virus, human herpesvirus 8) and human adenovirus species B, C, and F. Eighteen patients (46\%; 95\% CI, 32-61) had a bacteria-associated infection that included Haemophilus influenza, Haemophilus aegyptius, Staphylococcus aureus, Streptococcus pneumoniae, and Moraxella spp. Antimicrobial resistance determinants were detected in either the conjunctiva or nasal samples of 20 patients (32\%; 95\% CI, 22-45) and were found to be more diverse in the nose (Shannon alpha diversity, 1.12 [95\% CI, 1.05-1.26] versus 1.02 [95\% CI, 1.00-1.05], P = 0.01). These results suggest the potential utility of leveraging RNA-seq to surveil pathogens and AMR for ocular infections.

}, issn = {1476-1645}, doi = {10.4269/ajtmh.23-0498}, author = {Amza, Abdou and Nassirou, Beido and Kadri, Boubacar and Ali, Saley and Mariama, Boubacar and Ibrahim, Ciss{\'e} Mamadou and Roufaye, Lamine Aboubacar and Lebas, Elodie and Colby, Emily and Zhong, Lina and Chen, Cindi and Ruder, Kevin and Yu, Danny and Liu, YuHeng and Abraham, Thomas and Chang, Aaron and Mai, Lina and Hinterwirth, Armin and Seitzman, Gerami D and Lietman, Thomas M and Doan, Thuy} }