Differential Antimicrobial Efficacy of Preservative-Free Contact Lens Disinfection Systems against Common Ocular Pathogens

Walters, Rhonda; Campolo, Allison; Miller, Elise; McAnally, Cindy; Gabriel, Manal M.; Shannon, Paul; Crary, Monica

doi:10.1128/spectrum.02138-21

Cited by 8 publications

(15 citation statements)

References 30 publications

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“…To determine MPS disinfection efficacy of Acanthamoeba in different cellular formations ( Figure 7 ), Acanthamoeba were assessed for biocide resistance in either trophozoite, cyst, or spheroid forms after cells had been allowed to adhere (or aggregate) in plates for 12 or 24 h ( Figure 11 ). Consistent with published findings ( Gabriel et al, 2019 ; Walters et al, 2022 ), cells in the trophozoite form were the most susceptible to MPS biocides while cysts were significantly more challenging to disinfect. PAPB/PQ showed little ability to kill any form, with 100% survival for spheroids and cysts across all cell concentrations.…”

Section: Resultssupporting

confidence: 91%

“…As previously described ( Walters et al, 2022 ), trophozoites were axenically cultured in AC6 media (axenic culture medium, containing 20 g biosate peptone, 5 g glucose, 0.3 g KH 2 PO 4 , 10 μg vitamin B12, and 15 mg L-methionine per liter of distilled deionized water). Media was adjusted to a pH of 6.6–6.95 with 1 M NaOH and autoclaved at 121°C for 20 min before storing at room temperature for use within 3 months.…”

Section: Methodsmentioning

confidence: 99%

“…Spheroid age was between 2 and 72 h depending on the images. Prior to aggregation experiments, control trophozoites and cysts [pre-generated separately via starvation ( Walters et al, 2022 )] were stained to verify stain response to cells. No control cells were added to aggregation experiments.…”

Section: Methodsmentioning

confidence: 99%

“…Acanthamoeba exists either in the motile, infective trophozoite form or as the more resistant, persistent cyst form, which can remain viable for years ( Mazur et al, 1995 ; Siddiqui and Khan, 2012 ). Cysts are notoriously difficult to eradicate versus the trophozoite form, and have been shown to be impervious to most disinfection methods that do not involve hydrogen peroxide or povidone iodine ( Johnston et al, 2009 ; Coulon et al, 2010 ; Ahearn et al, 2012 ; Walters et al, 2022 ). While not generally considered a social amoebae like Dictyostelium , which can become a multicellular structure during their lifecycle, Acanthamoeba has been shown in the literature as forming clumps of cysts.…”

Section: Introductionmentioning

confidence: 99%

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Acanthamoeba spp. aggregate and encyst on contact lens material increasing resistance to disinfection

et al. 2022

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IntroductionAcanthamoeba keratitis is often caused when Acanthamoeba contaminate contact lenses and infect the cornea. Acanthamoeba is pervasive in the environment as a motile, foraging trophozoite or biocide-resistant and persistent cyst. As contact lens contamination is a potential first step in infection, we studied Acanthamoeba’s behavior and interactions on different contact lens materials. We hypothesized that contact lenses may induce aggregation, which is a precursor to encystment, and that aggregated encystment would be more difficult to disinfect than motile trophozoites.MethodsSix clinically and/or scientifically relevant strains of Acanthamoeba (ATCC 30010, ATCC 30461, ATCC 50370, ATCC 50702, ATCC 50703, and ATCC PRA-115) were investigated on seven different common silicone hydrogel contact lenses, and a no-lens control, for aggregation and encystment for 72 h. Cell count and size were used to determine aggregation, and fluorescent staining was used to understand encystment. RNA seq was performed to describe the genome of Acanthamoeba which was individually motile or aggregated on different lens materials. Disinfection efficacy using three common multi-purpose solutions was calculated to describe the potential disinfection resistance of trophozoites, individual cysts, or spheroids.ResultsAcanthamoeba trophozoites of all strains examined demonstrated significantly more aggregation on specific contact lens materials than others, or the no-lens control. Fluorescent staining demonstrated encystment in as little as 4 hours on contact lens materials, which is substantially faster than previously reported in natural or laboratory settings. Gene expression profiles corroborated encystment, with significantly differentially expressed pathways involving actin arrangement and membrane complexes. High disinfection resistance of cysts and spheroids with multi-purpose solutions was observed.DiscussionAggregation/encystment is a protective mechanism which may enable Acanthamoeba to be more disinfection resistant than individual trophozoites. This study demonstrates that some contact lens materials promote Acanthamoeba aggregation and encystment, and Acanthamoeba spheroids obstruct multi-purpose solutions from disinfecting Acanthamoeba.

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Section: Resultssupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acanthamoeba spp. aggregate and encyst on contact lens material increasing resistance to disinfection

et al. 2022

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“…However, in commercially available MPS, activity is variable even in solutions containing similar formulations of antimicrobial agents [ 6 , 7 , 8 , 9 ]. To overcome this issue, there are newer formulations of MPS, including ACUVUE™ RevitaLens (JnJvision, Jacksonville, FL, USA), which combines the biguanide alexidine with the quaternary ammonium compound polyquaternium-1 (PQ-1), and Biotrue ® (Bausch & Lomb, Rochester, NY, USA), which combines the polyaminopropyl-biguanide (PAPB) with PQ-1 to increase antimicrobial activity.…”

Section: Introductionmentioning

confidence: 99%

The Activity of PHMB and Other Guanidino Containing Compounds against Acanthamoeba and Other Ocular Pathogens

et al. 2022

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In recent years, a rise in the number of contact lens users in the UK and worldwide coincided with an increased incidence of microbial keratitis. The aim of this study was to investigate the antimicrobial activities of polyhexamethylene guanidine (PHMG), polyaminopropyl biguanide (PAPB), and guazatine in comparison to the common contact lens disinfectant constituent, polyhexamethylene biguanide (PHMB). The study investigated these compounds against a broad range of organisms, including Acanthamoeba castellanii, Acanthamoeba polyphaga, Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. This study demonstrated that PHMG, PAPB, and guazatine are equal in activity to PHMB against Acanthamoeba trophozoites and cysts. PHMG and PAPB are also equal in activity to PHMB against S. aureus and P. aeruginosa, whereas PHMG shows significantly better activity than PHMB against C. albicans (p < 0.001). To our knowledge, this is the first study to demonstrate the effectiveness of PHMB, PHMG, PAPB, and guazatine against Acanthamoeba and other ocular pathogens. As alternatives to PHMB, these compounds warrant further investigation for inclusion in contact lens solutions and for the treatment of keratitis.

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Advances in Contact Lens Care Solutions: PVP-I Disinfectant and HAD Wetting Agents From Japan

Itokawa,

Yamasaki,

Suzuki

et al. 2023

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Half of the individuals who wear contact lenses use reusable lenses that require proper care. Improper contact lens (CL) care and using inadequate disinfecting solutions can lead to lens contamination, CL-related microbial keratitis, and Acanthamoeba keratitis. Oxidative disinfecting solutions, such as hydrogen peroxide, show higher efficacy than multipurpose solutions. Povidone–iodine (PVP-I), an oxidative disinfectant used in ophthalmic surgery, has been proven to be safe and effective. The PVP-I system, a CL disinfecting solution developed in Japan, has demonstrated excellent antimicrobial and antiviral properties. Although CL discomfort does not have a risk of ocular disorders with poor visual prognosis, such as keratitis, CL discomfort can still lead to lens dropout and thus needs to be addressed. To mitigate CL discomfort, it is essential to use disinfecting solutions containing surfactants and wetting agents that improve wettability of the lens surface. A CL solution containing hyaluronic acid derivatives (HADs) as wetting agents that permanently adhere to the lens surface to improve wettability of the lens surface was developed in Japan. There is potential for HAD to be integrated into various solutions. This article reviews the efficacy of novel PVP-I–based disinfecting solution and HAD wetting agents.

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Differential Antimicrobial Efficacy of Preservative-Free Contact Lens Disinfection Systems against Common Ocular Pathogens

Abstract: Understanding the most efficacious products will allow clinicians to best communicate to patients and consumers the safest products on the market to reduce adverse events, including microbial keratitis, during contact lens use.

Cited by 8 publications

References 30 publications

Acanthamoeba spp. aggregate and encyst on contact lens material increasing resistance to disinfection

Acanthamoeba spp. aggregate and encyst on contact lens material increasing resistance to disinfection

The Activity of PHMB and Other Guanidino Containing Compounds against Acanthamoeba and Other Ocular Pathogens

Advances in Contact Lens Care Solutions: PVP-I Disinfectant and HAD Wetting Agents From Japan

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