An Outbreak of Fusarium Keratitis Associated With Contact Lens Use in the Northeastern United States

Gorscak, Jason J.; Ayres, Brandon D.; Bhagat, Neelakshi; Hammersmith, K.M.; Rapuano, Christopher J.; Cohen, Elisabeth J.; Burday, Michele; Mirani, Neena; Jungkind, Donald; Chu, David

doi:10.1097/ico.0b013e318142b932

Cited by 59 publications

(32 citation statements)

References 38 publications

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“…61 The incidence has progressively increased even after the recent Fusarium keratitis epidemic. 62 Fungi can be resistant to the activity of several contact lens multipurpose disinfecting solutions. 63 Furthermore, a recent study investigating in vitro antimicrobial activity of three commercially available silver impregnated contact lens cases revealed high activity against bacteria, but all the lens cases were essentially ineffective against C. albicans after 6, 10, and 24 hours, 64 and only one lens case showed limited activity (0.5 log) against Fusarium solanii.…”

Section: Discussionmentioning

confidence: 99%

Broad Spectrum Antimicrobial Activity of Melimine Covalently Bound to Contact Lenses

Dutta

Cole

Kumar

et al. 2013

Invest. Ophthalmol. Vis. Sci.

113

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PURPOSE. To develop a stable antimicrobial contact lens, which is effective against the International Organization for Standardization (ISO) panel microorganisms, Acanthamoeba castellanii and drug resistant strains of Pseudomonas aeruginosa and Staphylococcus aureus. METHODS.Melimine was covalently incorporated into etafilcon A lenses. The amount of peptide present on the lens surface was quantified using amino acid analysis. After coating, the heat stability (1218C), lens surface hydrophobicity (by captive bubble), and in vitro cytotoxicity to mouse L929 cells of the lenses were investigated. Antimicrobial activity against the micro-organisms was evaluated by viable plate count and fluorescence microscopy, measuring the proportion of cell death compared with control lenses with no melimine. RESULTS.The most effective concentration was determined to be 152 6 44 lg lens À1 melimine on the lens surface. After coating, lenses were relatively hydrophilic and were nontoxic to mammalian cells. The activity remained high after autoclaving (e.g., 3.1, 3.9, 1.2, and 1.0 log inhibition against P. aeruginosa, S. aureus, A. castellanii, and Fusarium solani, respectively). Fluorescence microscopy confirmed significantly reduced (P < 0.001) adhesion of viable bacteria to melimine contact lenses. Viable count confirmed that lenses were active against all the bacteria and fungi from the ISO panel, Acanthamoeba and gave at least 2 log inhibition against all the multidrug resistant S. aureus and P. aeruginosa strains.CONCLUSIONS. Melimine may offer excellent potential for development as a broad spectrum antimicrobial coating for contact lenses, showing activity against all the bacterial and fungal ISO panel microorganisms, Acanthamoeba, and antibiotic resistant strains of P. aeruginosa and S. aureus. (Invest Ophthalmol Vis Sci.

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Section: Discussionmentioning

confidence: 99%

Broad Spectrum Antimicrobial Activity of Melimine Covalently Bound to Contact Lenses

Dutta

Cole

Kumar

et al. 2013

Invest. Ophthalmol. Vis. Sci.

113

View full text Add to dashboard Cite

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“…[3][4][5][6][7][8][9][10][11][12] The causative organism varies greatly by location [3][4][5][6][7][8][9][10][11][12][13][14][15] and risk factors. 3,[11][12][13][14][15][16][17][18][19][20] Filamentous fungi, which tend to predominate as the causative organism in warm, moist climates, 1,3,6,7,12 are associated with the risk factors of trauma 1,3,6,7,12 and contact lens wear. 10,[13][14][15][17][18][19]…”

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confidence: 99%

Outcomes of Treatment of Fungal Keratitis at the University of Iowa Hospitals and Clinics

Rogers

Goins

Sutphin

et al. 2013

Cornea

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“…Candida albicans is one such opportunistic pathogen that may cause corneal infection following trauma or surgery or under immunosuppressive conditions, such as the prolonged use of corticosteroids and topical anesthetic abuse (7-12). Although the fungal keratitis is rare, the incidence has increased in recent years, especially in contact lens wearers (13,14). To date, there is no clinically amenable measure to prevent fungal keratitis.…”

mentioning

confidence: 99%

Chitinase 3-Like 1 Promotes Candida albicans Killing and Preserves Corneal Structure and Function by Controlling Host Antifungal Responses

Gao

2015

Infect Immun

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Chitinase 3-like 1 (CHI3L1) has been shown to play a role in promoting antibacterial responses, decreasing tissue injury, and enhancing pulmonary repair. This study sought to elucidate the role of CHI3L1 in augmenting the corneal innate immune response to Candida albicans infection in an animal model of fungal keratitis. Flagellin applied topically 24 h prior to C. albicans inoculation significantly protected the corneal from C. albicans and induced CHI3L1 expression in C57BL/6 mouse corneas. CHI3L1, however, played a detectable but minor role in flagellin-induced protection. While C. albicans keratitis was more severe in the corneas treated with Chi3l1 small interfering RNA (siRNA), corneas treated with recombinant CHI3L1 before C. albicans inoculation had markedly ameliorated keratitis, reduced fungal load, and decreased polymorphonucleocyte (PMN) infiltration in an interleukin 13 receptor ␣2 (IL-13R␣2)-dependent manner. CHI3L1 treatment resulted in the induction of the antimicrobial peptides ␤-defensin 3, CRAMP, and chemokine CXCL10 and its receptor CXCR3 in corneal epithelial cells. Importantly, CHI3L1 administered after C. albicans inoculation also had strong protection against fungal keratitis, suggesting a therapeutic window. This is the first report demonstrating that CHI3L1 is induced during fungal infection, where it acts as an immunomodulator to promote fungal clearance and to regulate antifungal innate immune responses in the cornea.T he cornea's visual properties are exquisitely sensitive to inflammation-mediated damage. The cornea is an immuneprivileged site with multiple anatomical, physiological, and immunoregulatory processes that inhibit many innate and adaptive immune responses (1, 2). As such, a normal cornea is remarkably resistant to infection. However, when the epithelial barrier function is breached (3), which may occur during routine contact lens wear, opportunistic pathogens such as bacteria and fungi gain access to the deeper cellular layers of the epithelium and colonize the cornea (4). This leads to the engagement of intraepithelially expressed Toll-like receptors (TLRs) with invading pathogens (5), resulting in the abrogation of immune privilege and the reactivation of the innate immune response (6). Candida albicans is one such opportunistic pathogen that may cause corneal infection following trauma or surgery or under immunosuppressive conditions, such as the prolonged use of corticosteroids and topical anesthetic abuse (7-12). Although the fungal keratitis is rare, the incidence has increased in recent years, especially in contact lens wearers (13,14). To date, there is no clinically amenable measure to prevent fungal keratitis. Current practice in treating fungal keratitis involves the use of topical antifungal drops, such as natamycin and amphotericin B. Topical antifungals can have toxic effects, such as punctate keratitis and recurrent corneal epithelial erosions (15). Hence, understanding the pathogenesis of fungal keratitis and host responses will aid in identifying new the...

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An Outbreak of Fusarium Keratitis Associated With Contact Lens Use in the Northeastern United States

Cited by 59 publications

References 38 publications

Broad Spectrum Antimicrobial Activity of Melimine Covalently Bound to Contact Lenses

Broad Spectrum Antimicrobial Activity of Melimine Covalently Bound to Contact Lenses

Outcomes of Treatment of Fungal Keratitis at the University of Iowa Hospitals and Clinics

Chitinase 3-Like 1 Promotes Candida albicans Killing and Preserves Corneal Structure and Function by Controlling Host Antifungal Responses

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