One- and two-step hydrogen peroxide contact lens disinfection solutions against Acanthamoeba: How effective are they?

Hiti, K.; Walochnik, Julia; Faschinger, Christoph; Em, Haller-Schober; Aspöck, Horst

doi:10.1038/sj.eye.6701752

Cited by 39 publications

(28 citation statements)

References 25 publications

(23 reference statements)

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“…Studies demonstrate that nearly all rigid and soft contact lens solutions sold in the United States have inadequate Acanthamoeba disinfection efficacy (1,3,4,5,12,13,14,16,19,20,25,26,37,39).…”

Section: Discussionmentioning

confidence: 99%

Resistance of Acanthamoeba Cysts to Disinfection in Multiple Contact Lens Solutions

Johnston¹,

Sriram²,

Qvarnström³

et al. 2009

J Clin Microbiol

114

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Acanthamoebae are free-living amoebae found in the environment, including soil, freshwater, brackish water, seawater, hot tubs, and Jacuzzis. Acanthamoeba species can cause keratitis, a painful vision-threatening infection of the cornea, and fatal granulomatous encephalitis in humans. More than 20 species of Acanthamoeba belonging to morphological groups I, II, and III distributed in 15 genotypes have been described. Among these, Acanthamoeba castellanii, A. polyphaga, and A. hatchetti are frequently identified as causing Acanthamoeba keratitis (AK). Improper contact lens care and contact with nonsterile water while wearing contact lenses are known risk factors for AK. During a recent multistate outbreak, AK was found to be associated with the use of Advanced Medical Optics Complete MoisturePlus multipurpose contact lens solution, which was hypothesized to have had insufficient anti-Acanthamoeba activity. As part of the investigation of that outbreak, we compared the efficacies of 11 different contact lens solutions against cysts of A. castellanii, A. polyphaga, and A. hatchetti (the isolates of all species were genotype T4), which were isolated in 2007 from specimens obtained during the outbreak investigation. The data, generated with A. castellanii, A. polyphaga, and A. hatchetti cysts, suggest that the two contact lens solutions containing hydrogen peroxide were the only solutions that showed any disinfection ability, with 0% and 66% growth, respectively, being detected with A. castellanii and 0% and 33% growth, respectively, being detected with A. polyphaga. There was no statistically significant difference in disinfection efficacy between the 11 solutions for A. hatchetti.Acanthamoebae, which are free-living amoebae, occur worldwide in soil and water. It has been isolated from ponds, lakes, brackish water. and seawater; filters of heating, ventilating, and air-conditioning units; medical equipment, such as gastric wash tubing, dental irrigation units, contact lenses, and contact lens solutions; as well as vegetables, cell cultures, and even human and animal tissues (7,23,39). It has also been isolated from toxic waste dumpsites with high levels of pesticides, herbicides, pharmaceuticals, heavy metals, and polychlorinated biphenyls (35). Acanthamoeba species have two stages in their life cycle: a vegetative or trophozoite stage that reproduces by binary fission and that feeds voraciously on the bacteria and detritus present in the environment and a nondividing, cyst stage that is resistant to environmental stress. Acanthamoeba amoebae cause different types of human disease, including central nervous system infections (granulomatous amebic encephalitis, cutaneous infections) Acanthamoeba dermatitis, and ocular infections (Acanthamoeba keratitis [AK]). Granulomatous amebic encephalitis and cutaneous infections principally occur in immunocompromised individuals, including patients with human immunodeficiency virus infection or AIDS (17,23,37,43). In contrast, AK principally occurs in immunocompetent individuals.

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Section: Discussionmentioning

confidence: 99%

Resistance of Acanthamoeba Cysts to Disinfection in Multiple Contact Lens Solutions

Johnston¹,

Sriram²,

Qvarnström³

et al. 2009

J Clin Microbiol

114

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“…The literature surrounding contact lens disinfection varies in methodology and subsequent results may be misleading [12]. The unfortunate fact is that most commercially available contact lens-disinfection solutions are ineffective against Acanthamoeba [13][14][15].…”

Section: Risk Factorsmentioning

confidence: 99%

Diagnosis and management of Acanthamoeba keratitis

Hammersmith¹

2006

Current Opinion in Ophthalmology

133

103

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Acanthamoeba keratitis continues to be a difficult infection to diagnose and manage. The frequency of these infections may be on the rise, most commonly associated with frequent replacement soft contact lenses. The best chance for a good outcome is based on early diagnosis, so it is important for ophthalmologists consider it in patients, especially in the contact lens wearer with suspected herpes simplex keratitis.

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“…While the underlying mechanism for this risk remains unknown, none of the widely-used multipurpose solutions have been shown to be highly efficacious against Acanthamoeba; however they have generally been adequate to suppress large AK outbreaks in the past. 8,[30][31][32][33][34][35][36] This suggests the risk presented by use of Complete MoisturePlus may be a relative inability to withstand an Acanthamoeba challenge compared to that of other solutions. Results similarly demonstrate non-statistically significant patterns of risk suggesting hygiene-and potentially water-related factors such as showering with contact lenses may contribute to AK.…”

Section: -58mentioning

confidence: 99%

The Association of Contact Lens Solution Use and Acanthamoeba Keratitis

Joslin

Shoff

et al. 2007

American Journal of Ophthalmology

217

152

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Purpose-Diagnosis of Acanthamoeba keratitis, a rare but serious corneal infection, has recently increased significantly at the University of Illinois at Chicago (UIC) Cornea Service. The purpose is to investigate Acanthamoeba keratitis risk factors.Design-Retrospective case-control study. Results-Thirty-nine (73.6%) cases and 113 (65.3%) controls participated; 38 cases had complete contact lens data. Thirty-five of 38 cases (92.1%) and 47 of 100 controls (47.0%) used soft lenses. Analysis was performed on 30 cases and 39 controls with matched pairs with soft lens use. Exclusive use of AMO Complete MoisturePlus Multi-Purpose Solution was independently associated with Acanthamoeba keratitis in multivariable analysis (55.2% vs. 10.5%; OR, 16.67; 95% CI, 2.11-162.63; p = 0.008). However, 38.8% of cases reported no use of AMO Complete MoisturePlus MultiPurpose Solution or used it in combination with other solutions. Although not statistically significant, additional hygiene-related variables (solution 'reuse', lack of 'rubbing', and showering with lenses) suggest a pattern of risk,. Conclusions-AMO Complete MoisturePlusMulti-Purpose Solution use is independently associated with Acanthamoeba keratitis among soft contact lens users. However, it does not explain all cases, suggesting additional factors. Further research into environmental risk factors and hygiene

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One- and two-step hydrogen peroxide contact lens disinfection solutions against Acanthamoeba: How effective are they?

Cited by 39 publications

References 25 publications

Resistance of Acanthamoeba Cysts to Disinfection in Multiple Contact Lens Solutions

Resistance of Acanthamoeba Cysts to Disinfection in Multiple Contact Lens Solutions

Diagnosis and management of Acanthamoeba keratitis

The Association of Contact Lens Solution Use and Acanthamoeba Keratitis

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