The evolution of antimicrobial resistant pathogens is regarded as clinical “super challenges” of the 21st Century. In ophthalmology, infectious keratitis remains one of the most important causes of corneal blindness globally, and is especially prevalent in Asia, while endophthalmitis remains the most devastating complication following elective ophthalmic surgery at a global level.
Fungal infections, and the development of antimicrobial resistant bacterial infections remain major global challenges affecting populations today. At the same time, there has been a marked decrease in discovery and development of new antibiotics owing to unfavourable economic return and challenges in gaining approval. In addition, advances in the medical materials have brought about the use of metals and plastics for restoring or replacing the damaged body parts. However, harmful bacteria and fungus adhered to surgical tools, contact lenses, lens cases, medical implants and fixation devices pose significant threat to the patients. If unchecked, the colonised bacteria may increase hospital stay duration, costs as well as affect the quality of life leading to increased number of deaths.
An estimated 1.4 million people suffer from infectious complications acquired in the hospitals every year. With the world population ageing rapidly, there will be a large number of elderly patients who are immunocompromised and more susceptible to infections, many times stemming from surgical sites, burns, chronic wounds, catheter insertion sites or contact lens infections, among others.
The ultimate aim of our group is to collaborate with peers around the world to understand the evolution of antimicrobial resistance among the infectious keratitis patients as well as to develop strategies that might accelerate the rational design of antimicrobials and antimicrobial formulations.
Core Competencies
The research and development capability of The Ocular Anti Infective & Inflammation Research Group has been achieved through a series of outstanding collaborations with local and overseas universities and institutes. Our important participating universities or institutes include Singapore National Eye Center, Bio-Informatics Institute, Institute of Materials Research & Engineering, Tan Tock Seng Hospital, Burn Centre@Singapore General Hospital, Lee Kong Chian (LKC) School of Medicine (at Nanyang Technological University), Departments of Pharmacy and Mechanical Engineering (at National University of Singapore). In addition, we collaborate with overseas collaborators on various aspects of antimicrobials peptide design. Our key collaborators include the University of Liverpool, the University of Nottingham and the Tianjin University. The following are our core competencies:
Khor WB, Prajna VN, Garg P, Mehta JS, Xie L, Liu Z, Padilla MDB, Joo CK, Inoue Y, Goseyarakwong P, Hu FR, Nishida K, Kinoshita S, Puangsricharern V, Tan AL, Beuerman R, Young A, Sharma N, Haaland B, Mah FS, Tu EY, Stapleton FJ, Abbott RL, Tan DT; ACSIKS Group. The Asia Cornea Society Infectious Keratitis Study: A Prospective Multicenter Study of Infectious Keratitis in Asia. Am J Ophthalmol. 2018;195:161-170.
Agrawal R, Testi I, Bodaghi B, Barisani-Asenbauer T, McCluskey P, Agarwal A, Kempen JH, Gupta A, Smith JR, de Smet MD, Yuen YS, Mahajan S, Kon OM, Nguyen QD, Pavesio C, Gupta V; for COTS CON group. Collaborative Ocular Tuberculosis Study (COTS) Consensus Guidelines on the Management of Tubercular Uveitis - Report 2: Guidelines for Initiating Anti-Tubercular Therapy in Anterior Uveitis, Intermediate Uveitis, Panuveitis and Retinal Vasculitis. Ophthalmol. 2020;S0161-6420: 30598-4.
Agrawal R, Testi I, Mahajan S, Yuen YS, Agarwal A, Kon OM, Barisani-Asenbauer T, Kempen JH, Gupta A, Jabs DA, Smith JR, Nguyen QD, Pavesio C, Gupta V; Collaborative Ocular Tuberculosis Study Consensus Group. Collaborative Ocular Tuberculosis Study Consensus Guidelines on the Management of Tubercular Uveitis-Report 1: Guidelines for Initiating Antitubercular Therapy in Tubercular Choroiditis. Ophthalmology. 2020;S0161-6420: 30013-0.
Agrawal R, Gunasekeran DV, Raje D, Agarwal A, Nguyen QD, Kon OM, Pavesio C, Gupta V; Collaborative Ocular Tuberculosis Study Group. Global Variations and Challenges With Tubercular Uveitis in the Collaborative Ocular Tuberculosis Study. Invest Ophthalmol Vis Sci. 2018;59:4162-4171.
Agrawal R, Gunasekeran DV, Grant R, Agarwal A, Kon OM, Nguyen QD, Pavesio C, Gupta V; Collaborative Ocular Tuberculosis Study (COTS)–1 Study Group. Clinical Features and Outcomes of Patients With Tubercular Uveitis Treated With Antitubercular Therapy in the Collaborative Ocular Tuberculosis Study (COTS)-1. JAMA Ophthalmol. 2017;135:1318-1327.
Saraswathi P, Beuerman RW. Corneal Biofilms: From Planktonic to Microcolony Formation in an Experimental Keratitis Infection with Pseudomonas aeruginosa. Ocul Surf. 2015;13:331-45.
Venkatesh M; Barathi VA; Goh ETL; Angaara R; Fazil MHUT; Ng AJY; Aung TT; Liu S; Yang L; Loh XJ; Beuerman RW; Verma NK; Lakshminarayanan R. Antimicrobial Activity and cell selectivity of synthetic and biosynthetic cationic polymer. Antimicrob. Agents Chemother. 2017;61. pii: e00469-17.
Venkatesh M, Xi Q, Goh ETL, Toh TYJ, Barathi VA, Fazil MHUT, Varadharajan J, Ting DSJ, Beuerman RW, Chan LW, Agrawal R, Barkham TMS, Verma NK, Lakshminarayanan R. Rational substitution of -lysine for -lysine enhances the cell and the membrane selectivity of pore-forming melittin. J Med Chem. 2020;63:3522-3537.
Aung TT, Chor WHJ, Lynn MN, Chan ASY, Tan DTH, Beuerman RW. Rabbit Fungal Keratitis Model of Fusarium solani Tested Against Three Commercially Available Antifungal Drugs. Eye Contact Lens. 2020 (In Press)
Dhand C; Venkatesh M; Barathi VA; Harini S; Bairagi S; Goh ETL; Nandhakumar M; Low KZW; Fazil MHUT; Verma NK; Loh XJ; Liu SP; Beuerman RW; Ramakrishna S; Lakshminarayanan R. Bio-inspired crosslinking and matrix-drug interactions for advanced wound dressings with long-term antimicrobial activity. Biomaterials. 2017;138:153-168.
Venkatesh M, Choong ACW, Dhand C, Lim FP, Tun AT, Sriram H, Dwivedi N, Periayah MH, Sridhar S, Fazil MHUT, Goh ETL, Orive G, Beuerman RW, Barkham TMS, Liang ZX, Barathi VA, Ramakrishna S, Chong SJ, Verma NK, Lakshminarayanan R. Multifunctional Antimicrobial Nanofiber Dressings Containing ε-Polylysine for the Eradication of Bacterial Bioburden and Promotion of Wound Healing in Critically Colonized Wounds. ACS Appl Mater Interfaces. 2020;12: 15989-16005.
Dhand C, Ong CY, Dwivedi N, Venkatesh M, Goh ETL, Chan LW, Beuerman RW, Foo LL, Loh XJ, Lakshminarayanan R. Mussel-Inspired Durable Antimicrobial Contact Lenses: The Role of Covalent and Non-covalent Attachment of Antimicrobials. ACS Biomat Sci Eng. 2020;5: 3162-3173.
Balne PK; Harini S; Dhand C; Dwivedi N; Chalasani MS; Verma NK; Barathi VA; Beuerman RW; Agrawarl R and Lakshminarayanan R. Surface characteristics and antimicrobial properties of modified catheter surfaces by pyrogallol and metal ions. Mater. Sci. Eng. C Mater. Biol. 2018;90: 673-684.
Tan XW; Goh TW; Saraswathi P; Nyein CL; Setiawan M; Riau A; Lakshminarayanan R; Liu SP; Tan D; Beuerman RW; Mehta JS. Effectiveness of antimicrobial peptide immobilization for preventing perioperative cornea implant-associated bacterial infection. Antimicrob. Agents Chemother. 2014; 58: 5229-5383.
Co-Heads
Assoc Prof R. Lakshminarayanan, PhD
Adj Assoc Prof Rupesh Agrawal, MD
Key Personnel
Aradhana Upadhyay, PhD, SERI
Mercy Hallayluyah Periayah, PhD, SERI
Mayandi Venkatesh, SERI
Eunice Goh Tze Leng
Antonio Lourdes Delos Santos, SERI
Collaborators
Clin Prof Donald TH Tan, MD, SNEC
Prof Roger W Beuerman, PhD, SERI
Prof Jod S Mehta, MD, SERI/SNEC
Dr Chandra S Verma, BII
Assoc Prof Loh XJ, IMRE
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