Contact lens-related microbial keratitis: recent outbreaks

Patel, Aavishkar A.; Hammersmith, K.M.

doi:10.1097/icu.0b013e3283045e74

Cited by 96 publications

(74 citation statements)

References 28 publications

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“…In another study (Patel and Hammersmith 2008), a literature review of infections in contact lenses and their relationship to the multi-purpose solutions was performed, which indicated a rise in infections caused by Acanthamoeba and Fusarium fungus. Moreover, it was found that multipurpose solutions are more effective against bacteria than against fungi and Acanthamoeba, and that these formulas are not as effective under real-world conditions.…”

Section: Discussionmentioning

confidence: 99%

Susceptibility of Acanthamoeba to multipurpose lens-cleaning solutions

Aguiar

Silveira

Winck

et al. 2013

Acta Parasitologica

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The present study investigated the susceptibility of Acanthamoeba spp. trophozoites to two multipurpose systems for cleaning and maintenance of contact lenses. Three strains of trophozoites from the ATCC (A. castellani T4, A. castellani Neff, and A. polyphaga) and two Acanthamoeba isolates obtained from swimming pools (PT5 and PO1) were placed in monoxenic culture. To test their survival in cleaning solutions for contact lenses, the trophozoites were exposed for 4 and 24 h to two multipurpose solutions (A and B), and were then inoculated into a new monoxenic culture. Amoebic growth on the plates was observed after 72 h of incubation. Trophozoites from all three ATCC strains and one isolate from a swimming pool (PO1) grew in all plates after 4 h of exposure to solutions A and B. After 24 h, the ATCC strains and the PO1 isolate showed growth in most of the plates treated. Only the PT5 isolate showed susceptibility to both solutions over the time intervals tested. The two solutions were not completely effective against most strains and isolates over the time intervals tested. These results are important, since species of Acanthamoeba are widely distributed in the environment and are potential agents of eye pathologies.

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Section: Discussionmentioning

confidence: 99%

Susceptibility of Acanthamoeba to multipurpose lens-cleaning solutions

Aguiar

Silveira

Winck

et al. 2013

Acta Parasitologica

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“…In recent years, the number of AK cases has been on the increase, especially among wearers of contact lenses, who make up 85 to 90% of the AK cases (8,24,31,35). Diagnosis of AK is problematic due to clinical features which are similar to those of herpetic, bacterial, and fungal infections.…”

mentioning

confidence: 99%

Molecular Identification of T4 and T5 Genotypes in Isolates from Acanthamoeba Keratitis Patients

et al. 2009

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Acanthamoeba keratitis (AK) is a rare but sight-threatening ocular infection. Outbreaks have been associated with contaminated water and contact lens wear. The epidemiology and pathology may be associated with unique genotypes. We determined the Rns genotype for 37 clinical isolates from 23 patients presenting at the University of Miami Bascom Palmer Eye Institute with confirmed AK infections in 2006 to 2008. The genus-specific ASA.S1 amplicon allowed for rapid genotyping of the nonaxenic cultures. Of the 37 isolates, 36 were of the T4 genotype. Within this group, 13 unique diagnostic fragment 3 sequences were identified, 3 of which were not in GenBank. The 37th isolate was a T5, the first in the United States and second worldwide to be found in AK. For five patients with isolates from the cornea and contact lens/case, identical sequences within each patient cluster were observed, confirming the link between contact lens contamination and AK infection. Genotyping is an important tool in the epidemiological study of AK. In this study, it allowed for the detection of new strains and provided an etiological link between source and infection. Additionally, it can allow for accurate categorizing of physiological differences, such as strain virulence, between isolates and clades.

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“…While the pathogenesis of contact lens-related Pseudomonas keratitis remains unclear, bacterial contamination of the eye appears to play a major role [2,20]. Although P. aeruginosa is the most important cause of contact lens-associated corneal ulcers, other bacteria, fungi, or Acanthamoeba may also cause this condition [1,[7][8][9][10][11][12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

“…Overall, contact lens disinfectants are more effective against bacteria than fungal species or Acanthamoeba [16]. There is no doubt that antimicrobial performance of contact lens disinfection systems is an important factor in reducing contamination.…”

Section: Introductionmentioning

confidence: 99%

Susceptibility of various corneal fungal isolates and Pseudomonas aeruginosa to contact lens disinfecting solutions

Pinna

Usai

Zanetti

et al. 2013

J Infect Dev Ctries

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Introduction: We aimed to investigate the susceptibility of a combined inoculum of Pseudomonas aeruginosa and different fungal strains to 6 soft contact lens disinfectants. Methodology: One corneal isolate of P. aeruginosa and 13 corneal fungal isolates (9 Aspergillus spp, 3 Fusarium spp, 1 Curvularia sp.) were used. The following solutions were tested: Arion Cronos, Complete RevitaLens, Dua Elite, Opti-Free Express, Regard, Oxysept Comfort, and Oxysept Comfort without catalase. The effect of the solutions was assessed on a combined inoculum of P. aeruginosa plus 1 fungal strain. Suspensions of P. aeruginosa and fungi were made in the solutions (1x10 6 colony-forming units/mL). After 1 hour (Arion Cronos only), 6, 8, and 24 hours, aliquots of suspension were removed and seeded on Luria-Bertani and Sabouraud agar plates. Results: After 6 hours' exposure, all the solutions but Dua Elite and Oxysept Comfort eradicated P. aeruginosa. Conversely, apart from 3% hydrogen peroxide-based Oxysept Comfort without catalase, which eradicated all the fungi tested after 6 hours, all the other solutions were partly ineffective at killing some of the fungal isolates, even after 24 hours' exposure. Conclusions: Most contact lens disinfectants may be ineffective if contact lens care systems become co-contaminated with P. aeruginosa and fungi. In our experiment, only exposure to 3% hydrogen peroxide without neutralizer for at least 6 hours was always able to kill a combined inoculum of P. aeruginosa and different fungal strains.

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Contact lens-related microbial keratitis: recent outbreaks

Abstract: There have been epidemic increases in Acanthamoeba and fungal keratitis associated with particular contact lens solutions. Further study of these atypical species is necessary. Greater emphasis should be placed upon efficacy of contact lens solutions rather than ease of use.

Cited by 96 publications

References 28 publications

Susceptibility of Acanthamoeba to multipurpose lens-cleaning solutions

Susceptibility of Acanthamoeba to multipurpose lens-cleaning solutions

Molecular Identification of T4 and T5 Genotypes in Isolates from Acanthamoeba Keratitis Patients

Susceptibility of various corneal fungal isolates and Pseudomonas aeruginosa to contact lens disinfecting solutions

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