Eye Coinfections

Abstract

Ocular infections are an ophthalmologic emergency that threatens the eye's integrity, which may result in a poor visual outcome; hence, it requires prompt treatment. The most common microorganisms involved in eye infection are the bacteria, followed by virus and fungi; however the prevalence depends on the geographic location. It is essential to know The etiologic agent of the ocular infection ocular infections and their antibiotic sensitivity because the geographical situation and the urbanization level of the studied population will determine their prevalence. Recently have been described eye coinfections, where at least two microorganisms can infect at the same time and the same anatomic site. Several coinfections have been published, bacteria-bacteria, bacteria-fungus, bacteria-virus, fungus-yeast, fungus-virus, parasite-bacteria, etc. Eye coinfections represent a particular challenge for the ophthalmologists; coinfections are difficult to diagnose because often the clinical characteristic is atypical and mimics different clinical pictures. In addition, eye coinfections respond poorly to antibiotics and usually present an aggressive clinical course. In these circumstances, it is common for patients to receive multiple treatments when they should be receiving a specific treatment. Several risk factors are important to develop coinfections, e.g., trauma, dry eye, use of contact lenses, and comorbidities (diabetes and immunosuppression). Coinfections have been described in keratitis, conjunctivitis, and endophthalmitis. The study of polymicrobial biofilms has been increasing, and in the medical area, the role played by biofilms in confections has been associated with virulence factors; hence, biofilm formation is also considered a determinant virulence factor for pathogenesis in the host. Coinfection diagnosis is an important topic in order to obtain a specific and timely diagnosis. Microbiological and molecular approaches are proposed to identify etiological agents. Delay in diagnosis affects the sensitivity to specific treatments and the evolution of infection. Treatment and prognosis are supported by a specific diagnosis.