Incidence of contact-lens-associated microbial keratitis and its related morbidity

Cheng, Kam H.; Leung, Siu Lan; Hoekman, Hans W; Beekhuis, W. H.; Mulder, Paul; Geerards, Annette J M; Kijlstra, Aize

doi:10.1016/s0140-6736(98)09385-4

Cited by 514 publications

(362 citation statements)

References 30 publications

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“…Those aged between 25 and 44 years had an increased risk of developing microbial keratitis compared with younger wearers aged between 14 and 24 years. Previous studies have described a higher risk in younger age groups, 3,13 and this finding is unexpected.…”

Section: Discussioncontrasting

confidence: 52%

“…Epidemiological studies of contemporary contact lenses have estimated the incidence of microbial keratitis in daily wear at 3 to 5 per 10 000 lens wearers per year, with incidence varying according to wear modality. [2][3][4][5][6] Risk factors that have been consistently identified may be categorised into either modifiable or nonmodifiable risk factors. Modifiable risk factors include extended and overnight contact lens wear, 7,8 poor hand hygiene, 4,9 infrequent or omission of lens disinfection, 7,8 case hygiene and case replacement, 6,10 and smoking.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for contact lens-related microbial keratitis in Singapore

Lim

Carnt

Farook

et al. 2015

Eye

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Purpose: To investigate independent risk factors for contact lens-related microbial keratitis in Singapore and estimate their impact on disease load. Methods: Cases were contact lens wearers presenting to Singapore National Eye Centre with microbial keratitis between 2008 and 2010. Community contact lens wearers were recruited as controls. All wearers completed a previously validated questionnaire describing contact lens wear history, hygiene and compliance habits, and demographics. Risk factors significant in univariate analysis (Po0.2) were evaluated in a multivariate model. Results: In all, 58 cases of microbial keratitis and 152 contemporaneous controls were identified. When controlling for other variables, Chinese had a 7 × lower risk compared with other races (95% CI: 2.3-21.3, P = 0.001). Those aged between 25 and 44 years were at 3 × increased risk compared with younger wearers (95% CI: 1.1-9.6, P = 0.04). Occasional overnight contact lens wear (less often than one night per week) was associated with a 4 × higher risk (95% CI: 1.2-15.4, P = 0.03) compared with daily use. Not washing hands before handling was associated with a 13 × increased risk (95% CI: 1.9-84.8, P = 0.008). Use of multipurpose solution A carried a 16 × higher risk compared with hydrogen peroxide (95% CI: 1.5-174.0, P = 0.02). The combined PAR% for modifiable risk factors (occasional overnight wear, not washing of hands, and MPS A) was 82%. Conclusions: Consistent with previous findings, independent risk factors for contact lens-related microbial keratitis include poor hand hygiene, occasional overnight wear, and type of lens care solution. Prolonged overnight or extended contact lens use was infrequent in this population.

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Section: Discussioncontrasting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Risk factors for contact lens-related microbial keratitis in Singapore

Lim

Carnt

Farook

et al. 2015

Eye

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“…4,5 Particularly important is the fact that in both higher and lower income countries corneal disease frequently affects people of working age, causing significant associated morbidity and visual impairment. 2,6 In most parts of the world bacteria are the leading pathogens and despite the use of antibiotics, irreversible corneal damage still occurs.…”

Section: Introductionmentioning

confidence: 99%

Pattern recognition receptors in microbial keratitis

Taube

Cendra

Elsahn

et al. 2015

Eye

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“…Pseudomonas aeruginosa keratitis is an acute sight-threatening infection that can occur as a complication of soft contact lens wear or corneal injury (Cheng et al, 1999;Alexandrakis et al, 2000;Lam et al, 2002;Watt and Swarbrick 2005;Verhelst et al, 2006;Bharathi et al, 2007;Pachigolla et al, 2007). Corneal isolates of P. aeruginosa can be divided into invasive or cytotoxic strain types based upon how they interact with epithelial cells (Fleiszig et al, 1996;Fleiszig et al, 1997;Cowell et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Mutation of the phospholipase catalytic domain of the Pseudomonas aeruginosa cytotoxin ExoU abolishes colonization promoting activity and reduces corneal disease severity

Tam

Lewis

et al. 2007

Experimental Eye Research

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We have previously shown that ExoU, a type III secreted cytotoxin of Pseudomonas aeruginosa, causes acute cytotoxicity towards corneal epithelial cells in vitro, and contributes to corneal disease pathology and ocular colonization in vivo. Subsequently, we reported that ExoU represses phagocyte infiltration of infected corneas in vivo. ExoU has patatin-like phospholipase activity that is required for cytotoxic activity in vitro (mammalian cell injury and death) and for disease in a murine model of pneumonia. We hypothesized that the phospholipase activity was required for ExoU-mediated corneal disease and ocular colonization. Using the murine scarification model, corneal disease pathology was examined after inoculation with ~10 6 cfu of a P. aeruginosa effector mutant (PA103ΔexoUexoT::Tc) complemented with either exoU (pUCPexoU), phospholipase-inactive exoU (pUCPexoUD344A) or a plasmid control (pUCP18). Eyes were photographed and disease severity scored at 24 and 48 h post-infection. Viable bacteria colonizing infected eyes were quantified at 6 and 48 h. Complementation with exoU caused significantly more pathology (increased disease severity scores) and enabled bacteria to better colonize (bỹ 1000-fold) at 48 h as compared to phospholipase-inactive exoU which did not differ from plasmid control. Surprisingly, exoU did not contribute to early (6 h) colonization. In-vitro assays confirmed that the phospholipase domain of exoU was required for cytotoxicity towards human corneal epithelial cells. Taken together these data show that the phospholipase activity of the P. aeruginosa cytotoxin, ExoU, plays a role in the pathogenesis of corneal infection via mechanism(s) occurring after initial colonization of a susceptible cornea.

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Incidence of contact-lens-associated microbial keratitis and its related morbidity

Cited by 514 publications

References 30 publications

Risk factors for contact lens-related microbial keratitis in Singapore

Risk factors for contact lens-related microbial keratitis in Singapore

Pattern recognition receptors in microbial keratitis

Mutation of the phospholipase catalytic domain of the Pseudomonas aeruginosa cytotoxin ExoU abolishes colonization promoting activity and reduces corneal disease severity

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