Epidemiological Characteristics of a Chicago-area Acanthamoeba Keratitis Outbreak

Joslin, Charlotte E.; Tu, Elmer Y.; McMahon, Timothy T.; Passaro, Douglas J.; Stayner, Leslie T.; Sugar, Joel

doi:10.1016/j.ajo.2006.04.034

Cited by 163 publications

(128 citation statements)

References 22 publications

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“…It has been previously reported that contact lens use is a major risk factor for AK. 1,2,4,8 Although some reports have suggested that the use of daily-disposable lenses poses only a low risk of AK, 5 seven of the AK patients examined in our study used this type of lens. However, it is difficult to use our results to generalise the level of risk of AK as the usage of daily-type contact lenses differs greatly among countries.…”

Section: Discussionmentioning

confidence: 91%

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Visual outcome in Japanese patients with Acanthamoeba keratitis

Yamazoe

Yamamoto

Shimazaki-Den

et al. 2012

Eye

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Purpose To identify prognostic factors affecting visual outcome in Acanthamoeba keratitis (AK) treated with topical chlorhexidine gluconate (CHG). Methods A total of 35 eyes in 34 patients with AK were treated with 0.02% topical CHG. Patients were divided into two groups according to the final visual outcome: Group 1, final visual acuity (VA) of 20/25 or greater (22 eyes); Group 2, less than 20/25 (13 eyes). We compared these groups and evaluated the effectiveness of topical CHG compared with outcomes in previous reports. Results Ring infiltrate was observed more often in Group 2 (4.5% vs 61.5%, OR 33.6, 95% confidence interval (CI) 3.4-333.9, Po0.01). The duration between onset and diagnosis of AK was significantly longer (24.9 days vs 48.4 days, OR 1.03, 95% CI 1.00-1.06, P ¼ 0.04) and VA at initial examination (log MAR) significantly lower (0.47 vs 1.59, OR 25.5, 95% CI 3.4-186.7, Po0.01) in Group 2 (visual outcome o20/25). Multivariate analysis revealed that only VA at initial examination was independently associated with worse visual outcome (adjusted OR 24.5, 95% CI 1.9-312.6, P ¼ 0.01). Seventeen (85.0%) of the 20 eyes diagnosed within 1 month and 24 (82.8%) of 29 eyes diagnosed within 2 months achieved a VA of 20/40 or greater. Conclusion VA at initial examination was the most predictive factors for final visual outcome in AK. Topical CHG was comparably effective to other treatments, including polyhexamethyl biguanide and propamidine isethionate.

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Section: Discussionmentioning

confidence: 91%

“…[1][2][3][4][5] However, specific treatment is not established, and there are some differences in the treatment between Western and Asian countries. In Japan, anti-fungal agents, corneal scraping, chlorhexidine gluconate (CHG), or some combination of these therapies are often used to treat AK.…”

Section: Introductionmentioning

confidence: 99%

Visual outcome in Japanese patients with Acanthamoeba keratitis

Yamazoe

Yamamoto

Shimazaki-Den

et al. 2012

Eye

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“…Epidemiological data has shown frequent cases of AK in several countries. The risk factors for AK and potential means of disease prevention have also been investigated (Kilvington et al, 2004;Joslin et al, 2006;Gatti et al, 2010;Patel et al, 2010;Cao et al, 2014;Bradbury et al, 2014). The known risk factors of AK are corneal injury, eye surgery (Shmuel et al, 2013;Arance-Gil et al, 2014), and contact lens use (Steiber et al, 2013;Stapleton et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

A Rabbit Model of Acanthamoeba Keratitis That Better Reflects the Natural Human Infection

Feng

Zheng

Wang

et al. 2015

The Anatomical Record

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Acanthamoeba species are ubiquitous, free-living protozoa that can invade the cornea and result in Acanthamoeba keratitis (AK), a painful progressive sight-threatening corneal disease. Disease progression in current animal models is too rapid to mimic AK in humans accurately. This study provides a novel method for establishing AK in rabbits and compared it with the conventional method with regard to pathogenesis and immune response in humans. The New Zealand white rabbits were randomly divided into two experimental groups (Groups A and B). Rabbits in the Group A (n 5 14) received intrastromal injections of 1 3 10 4 /100 mL Acanthamoeba healyi trophozoites (conventional AK model). The Group B animals (n 5 14) received microinjections of 1 3 10 4 /10 mL A. healyi trophozoites between the corneal epithelium and Bowman's layer, anterior to the corneal stroma (novel AK model). In addition, two rabbits were left untreated as normal controls. AK in the treated rabbits was evaluated clinically, histopathologically, and immunologically for 35 days. AK was successfully established in both the conventional and novel model groups. Compared with the Group A, AK in the Group B displayed an efficient immune response with less severe pathology. Moreover, the self-limiting but chronic nature of the infection in the Group B was strikingly similar to that of AK in humans. The novel animal model for AK described here more closely simulates the pathogenesis and immune response of Acanthamoeba corneal infection in humans than the animal models currently in use. Anat Rec, 298:1509Rec, 298: -1517Rec, 298: , 2015. V C 2015 Wiley Periodicals, Inc.

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“…5,32 Similar questions have been raised as to whether this increase constitutes an outbreak or a previously unrecognized background rate. Applying the same CDC criteria, the clinical aspect of the case definition for Acanthamoeba keratitis, although varied, has remained relatively consistent among past and present studies ranging from predominantly epithelial disease to deep stromal keratitis (Figures 1b-f) sometimes associated with extraocular manifestations and occurring predominantly in contact lens wearers.…”

Section: Recent Increases In Acanthamoeba Keratitismentioning

confidence: 99%

“…Several parasitic corneal pathogens have been well described, including Onchocerca, Leishmania, and Trypanosoma, 1,2 with recent attention focused on notable numbers of Microsporidia keratitis in South Asia and a more modest increase of Acanthamoeba keratitis in the United States as well as other developed countries. [3][4][5][6][7][8][9][10] Clinically, parasitic infections are usually characterized as chronic and intractable presenting with non-specific findings masquerading as other infectious and non-infectious disease. Despite the recent outbreaks, these infections remain comparatively rare, requiring a substantial clinical suspicion to warrant the specific media and/or special histological expertise for diagnosis.…”

Section: Introductionmentioning

confidence: 99%