Bacterial Biofilm Diversity in Contact Lens-Related Disease: Emerging Role ofAchromobacter,Stenotrophomonas, andDelftia

Abstract

PURPOSE. Multi-species biofilms associated with contact lens cases and lenses can predispose individuals to contact lensrelated inflammatory complications. Our study used cultureindependent methods to assess the relationship between the severity of contact lens-related disease and bacteria residing in biofilms of contact lens cases and lenses.METHODS. Contact lens cases and lenses from 28 patients referred to the West Virginia University Eye Institute and diagnosed as having mild keratitis, keratitis with focal infiltrates, or corneal ulcers were processed and evaluated for bacterial composition based on 16S ribosomal RNA gene sequencing. Cases and lenses from nine asymptomatic contact lens wearers were processed in a manner similar to controls. Relationships between disease severity, bacterial types, and bacterial diversity were evaluated statistically.RESULTS. Disease severity and presenting visual acuity correlated with an increase in the diversity of bacterial types isolated from contact lens cases. A significant difference also was observed in the number of bacterial types associated with the three clinical groups. Achromobacter, Stenotrophomonas, and Delftia were prevalent in all disease groups, and Achromobacter and Stenotrophomonas were present in one asymptomatic control. Scanning electron microscopy revealed that Achromobacter and Stenotrophomonas formed a biofilm on the surface of contact lenses.CONCLUSIONS. Culture-independent methods identified an association between disease severity and bacterial diversity in biofilms isolated from cases and lenses of patients with contact lens-related corneal disease. Achromobacter, Stenotrophomonas, and Delftia were predominant bacteria identified in our study, drawing attention to their emerging role in contact lensrelated disease. (Invest Ophthalmol Vis Sci. 2012;53:3896-3905)

Biofilm formation of Achromobacter xylosoxidans on contact lens

“…was predominant bacterium in patients with contact lens-related corneal disease, with occurrence of 76% of lens cases. This outcome was in part explained by the ability of Achromobacter to form biofilms on the surface of CL, which was confirmed by SEM analysis [8]. Some studies showed that Achromobacter spp.…”

“…Also, a study using scanning electron microscopy (SEM) showed that Achromobacter spp. were able to form biofilms on the surface of CL from patients with microbial keratitis [8]. To the best of our knowledge, there is no data describing the occurrence of A. xylosoxidans as a causative agent of contact lens-associated keratitis as well as a contaminant of contact lens cases in Serbia.…”

“…as following major causative pathogens [8]. The ability of P. aeruginosa, S. marcescens, and S. aureus to form biofilms on CL is well documented in the literature [2,7].…”

“…Thus, its role as an important pathogen may be underestimated, but recent studies showed that Achromobacter spp. may contaminate lenses, lens cases, and contact lens solutions and subsequently cause corneal infiltrative events (CIEs) [8,[10][11][12]. Based on a literature, there are 12 reported cases of A. xylosoxidans keratitis [12].…”

“…Based on a literature, there are 12 reported cases of A. xylosoxidans keratitis [12]. Infections due to A. xylosoxidans, as a water pathogen, are associated with humidifiers and disinfectants in hospitals, but contaminated hands can also spread the bacterium to the CL, lens solution, and lens case [8,12,13]. Also, a study using scanning electron microscopy (SEM) showed that Achromobacter spp.…”