Infectious Conjunctivitis: Causes, Mechanism of Action of Gentamicin, Signs, Infection Control Issues, Transmission, Breaking the Chain of Infection

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1. Background of the case study (Total: 5 marks)
1.1 What is infectious conjunctivitis?
Conjunctivitis is the inflammation of the conjunctivae which is the clear mucous
film which encircles the white layer of the eye. The Conjunctivitis happens due to
several factors such as the bacteria, viruses, fungi, chemicals and certain diseases.
Conjunctivitis is very contagious. Most viruses or bacteria which cause
conjunctivitis generally spread through hands to the eyes or by the contact of any
infectious object which contaminated by the infectious virus (Bishop, 2016a).
1.2 Of the four micro-organisms listed below, justify which one is more likely to be
the cause of John’s eye infection. Indicate why the other micro-organisms from the
list are least likely to cause the infection.
Legionella pneumophila
Yes or no, with reason:
Yes, but has less chance to cause contagious conjunctivitis, since it is a gram-
negative bacteria. It is the primary bacteria causing pneumonia, but can also cause
conjunctivitis (Bishop, 2016a).
Plasmodium ovale
Yes or no, with reason:
Since Plasmodium ovale is a protozoa thus it cannot cause conjunctivitis (Bishop,
2016b).
Adenovirus
Yes or no, with reason:
Yes Adenovirus can cause viral conjunctivitis (adenoviral keratoconjunctivitis)
(Bishop, 2016b)
Staphylococcus aureus
Yes or no, with reason:
Staphylococcus aureus is a gram positive bacterium which is the most usual reason
for conjunctivitis (Department of Health. 2017).
2. Mechanism of action and adverse reactions (Total: 5 marks)
2.1 Describe the mechanism of action of gentamicin?
The drug gentamicin irreversibly binds with the definite 30S subunit proteins and

16S rRNA. Gentamicin binds with four nucleotides of the 16S rRNA and one
amino acid of S12. This hinders with the surrounding decoding site of the of
nucleotide 1400 in the 16S rRNA of 30S subunit. This section links with the
wobble base in the anticodon of tRNA. Thus, this causes an hindrance with the
starting complex entity, which causes to misread the mRNA and leads to selection
and insertion of incorrect amino acids in the polypeptide region leading to
ineffective or toxic peptides and breakage of polysomes into ineffective monsomes
(Hill, Hall & Glew, 2017).
2.2 Name two adverse reactions of this drug?
Nausea, stomach ache, vomiting, kidney and nerve injury, vision issues, itching or
rash, pain in joint, loss of appetite, hearing loss are some of the adverse reactions
which occur due to intake of the gentamicin drug and also there many more
adverse reactions other than this (Hill, Hall & Glew, 2017).
3. Physiological basis of signs (Total: 10 marks)
3.1 sign 1:
John’s eyes were having sticky discharge and purulent
Explanation of this phenomenon:
The inflammation of the mucous and the ocular layer of the eye due to
conjunctivitis cause a discharge of excessive sticky and purulent fluid.
Due to extreme irritation of mucous and the ocular layers of the eye, along with the
tear glands, there is huge discharge of fluids which is also termed as epiphora. The
mucous layer releases its constituent through the tears and thus turns sticky and
purulent. The mucous constituent usually consist of different lysozymes,
immunoglobulins (Ig), glycoproteins and inorganic salts. According to some
researchers, the tears consist of mucous layer constituents has certain benefits. The
tears consist of the harmful constituents which are emitted from the eye aiding in