Comprehensive analysis of pathogens, resistomes, and inflammatorymarkers in the cornea

Kalua, Khumbo; Misanjo, Esther

Comprehensive analysis of pathogens, resistomes, and inflammatorymarkers in the cornea

Date

2022-09-08

Authors

Kalua, Khumbo

Misanjo, Esther

Publisher

Kamuzu University of Health Sciences

Abstract

Type of research study This will be a hospital-based, prospective, cross-sectional study which will be conducted at Lions Sight First Eye Hospital, as part of the global collaborative network. Problem to be studied A descriptive study on Pathogens, Resistomes, and Inflammatory-markers in the cornea at Lions sight first eye hospital (LSFEH) in Malawi. Objectives Main objective To identify etiology, antimicrobial resistance (AMR) and local host immune response, and correlate with presentation and outcome. Specific Objectives 1. To identify pathogens causing infectious keratitis in an unbiased manner. 2. To determine the optimal diagnostic technique (stains, cultures, MDS) for corneal ulcers. 3. To determine the effect of seasonality on pathogen profile and visual outcomes. 4. To determine the frequency and richness of AMR in pathogens causing keratitis. 5. To determine AMR genotype and phenotype correlation with clinical outcomes. 6. To determine the host transcriptional signatures for pathogen types. 7. To determine the host transcriptional signatures for clinical outcomes. Methodology The study will enroll all patients aged 1 month and above who will present at LSFEH with a corneal ulcer during the study period. A minimum sample size of 100 patients will be recruited in this study. All patients that will meet inclusion criteria will be administered a questionnaire. They will also undergo comprehensive anterior ocular examination. Ocular tissues sample will be collected from both eyes and will be used for high-throughput sequencing (conjunctival swabs, corneal swabs). High through put sequencing, in theory, should allow for the unbiased detection of any pathogen and biomarkers in a clinical sample. The sample will be stored in a minus 20 freezer up until the analysis is done. Expected findings This is a multicenter study, led by University of California San Francisco UCSFA (USA). It is expected that the spectrum of etiology will vary significantly with geographic location. In addition, seasonality will affect pathogen profile and disease outcomes. It is also expected that AMR will differ by global location and predict clinical outcome. Finally, it is hypothesized that immune signatures can predict pathogen types and clinical outcome. Dissemination The results will be disseminated at College of Medicine Research Ethics Committee (COMREC), hospital director for Queen Elizabeth central hospital (QECH), Malawi National Prevention of Blindness Committee, Ministry of Health (MOH) and brief presentation to clinical and nursing staff of Lions sight first eye hospital (LSFEH).