scholarly journals Contact Lens Associated Bacterial Keratitis: Common Organisms, Antibiotic Therapy, and Global Resistance Trends: A Systematic Review

2021 ◽  
Vol 1 ◽  
Author(s):  
Hossein Hatami ◽  
Amir Ghaffari Jolfayi ◽  
Ali Ebrahimi ◽  
Saeid Golmohammadi ◽  
Moein Zangiabadian ◽  
...  

IntroductionContact lens wearing has been increased globally during recent decades, which is one of the main risk factors for developing microbial keratitis. Microbial keratitis is a severe and dangerous condition that causes cornea inflammation. It can lead to corneal scarring and perforation or even endophthalmitis and visual loss if it remains untreated. Among bacterial, fungal, protozoal, and viral agents which can cause microbial keratitis, bacteria are the most common cause. Therefore, in this study, we aim to find common causative bacteria, sensitivity, and resistance to antibiotics and the outcome of antibiotic therapy in contact lens-related bacterial keratitis.MethodsA systematic search was carried out in PubMed/Medline, EMBASE, and Web of Science for published studies and medRxiv for preprints up to February 30, 2021, and May 14, 2021, respectively. A combination of the following keywords was used: “Infection”, “Corneal infection”, “Keratitis”, “Microbial keratitis”, and “Contact lens”, Also, we used the “Contact lenses” MeSH term. Lists of references for each selected article and relevant review articles were hand-searched to identify further studies.ResultsTwenty-six articles were included. From 1991 to 2018, 2,916 episodes of contact lens-related microbial keratitis) CLMK(with 1,642 episodes of proven bacterial keratitis have been reviewed in these studies. Studies were conducted in 17 countries with different geographical regions, and four studies were conducted in Iran, which is the highest number of studies among these countries. According to 20 studies, the mean age of patients was 30.77 years. Females with 61.87% were more than males in 19 studies. A percentage of 92.3% of patients used soft contact lenses, and 7.7% of patients used hard contact lenses (including RGP), according to 16 studies. Pseudomonas aeruginosa, Staphylococcus spp., and Serratia marcescens were the three most common bacteria isolated from samples of patients with contact lens-related bacterial keratitis. Overall, isolated bacteria were most sensitive to fluoroquinolones and aminoglycosides, especially ciprofloxacin and gentamicin respectively, and most resistant against penicillin and cephalosporins especially cefazolin and chloramphenicol. Almost all patients responded well to antibiotic therapy, with some exceptions that needed further surgical interventions.ConclusionAntibiotics are efficient for treating almost all patients with contact lens-related bacterial keratitis if they are appropriately chosen based on common germs in every geographical region and the sensitivity and resistance of these germs against them. In this regard, Pseudomonas aeruginosa is the most common causative germ of contact lens-associated bacterial keratitis all over the world and is almost fully sensitive to ciprofloxacin. Because of some different results about the sensitivity and resistance of germs against some antibiotics like gentamicin, vancomycin, and chloramphenicol in the Middle East region, especially Iran, more in vitro and clinical studies are suggested.

Antibiotics ◽  
2018 ◽  
Vol 7 (4) ◽  
pp. 88 ◽  
Author(s):  
Dinesh Subedi ◽  
Ajay Vijay ◽  
Mark Willcox

Background: The prevalence of disinfectant resistance in Pseudomonas aeruginosa is on the rise. P. aeruginosa is the most common bacteria isolated from cases of microbial keratitis. Many multi-purpose contact lens disinfectant solutions are available to decontaminate contact lenses before use and to help reduce the incidence of infections. However, with increasing disinfectant resistance, the effect of multi-purpose disinfectant solutions may diminish. The goal of this study was to examine genes associated with disinfectant resistance in ocular isolates of P. aeruginosa and understand the strain’s susceptibility to different multipurpose disinfectant solutions. Methods: Seven potential disinfectant resistance genes were used in BLASTn searches against the whole genomes of 13 eye isolates of P. aeruginosa. A microdilution broth method was used to examine susceptibility to four different multipurpose disinfectant solutions. Results: All strains possessed the sugE2, sugE3 and emrE (qacE) genes. The sugE1 and qacEdelta1 genes were present in 6/13 isolates. No strains contained the qacF or qacG genes. All tested disinfectant solutions had the ability to kill all test strains at 100% concentration, with some strains being susceptible at 1:8 dilutions of the disinfecting solutions. However, the presence of disinfectant resistance genes was not associated with susceptibility to multi-purpose disinfectants. Conclusion: All four tested contact lens disinfectant preparations are effective against P. aeruginosa isolates regardless of the presence of disinfectant resistance genes.


2021 ◽  
Vol 26 (3) ◽  
pp. 2626-2630
Author(s):  
EVELINA MILCHEVA MARINOVA ◽  
◽  
DIMITAR STOIMENOV DABOV ◽  
YANI TODOROV ZDRAVKOV ◽  
EMILIA KRASIMIROVA NASEVA ◽  
...  

Objective: The purpose of our research is to emphasize the role of underestimated predisposing conditions for microbial keratitis in contact lens users, to draw attention to the complications of wearing contact lenses without ophthalmic examination, and to offer a short questionnaire for fast and easy estimation of the risk factors for bacterial keratitis. Methods: A series of 23 cases of healthy young individuals, treated for bacterial keratitis, provoked а research on the predisposing factors for its development. Results: 55% of the patients had started to wear contact lenses without specific examination. 75% had made mistakes in the hygiene and storage of the lenses. We identified risk factors for development of bacterial keratitis in all cases. Conclusions: A thorough anamnesis and ophthalmic examination are crucial in decision making about contact lens wearing because they could reveal some of the predisposing conditions for the occurrence of ocular complications. The usage of contact lenses without a prescription poses health risks and could have a negative impact on the social and healthcare system.


2020 ◽  
Author(s):  
Edyta Beata Hendiger ◽  
Marcin Padzik ◽  
Agnieszka Żochowska ◽  
Wanda Baltaza ◽  
Gabriela Olędzka ◽  
...  

Abstract Background: Free living amoebae of Acanthamoeba genus are cosmopolitan, widely distributed protozoans causing severe, vision-threatening corneal infection known as Acanthamoeba keratitis (AK). Majority of the increasing number of AK cases are associated with contact lenses use. Due to lack of effective therapies against AK, proper eye hygiene and effective contact lenses disinfection are crucial in prevention of this infection. Currently available multipurpose contact lens disinfection systems are not fully effective against Acanthamoeba trophozoites and cysts. There is an urgent need to increase the disinfecting activity of these systems to prevent Acanthamoeba keratitis infections. Synthesized nanoparticles have been recently studied and proposed as a new generation of anti-microbial agents. It is also known that plant metabolites, including tannins, present anti-parasitic activity. The aim of this study was to evaluate the anti-amoebic activity and cytotoxicity of the tannic acid-modified silver nanoparticles (AgTANPs) conjugated with the selected multipurpose contact lens solutions.Methods: The anti-amoebic activity of pure contact lens care solutions and nanoparticles conjugated with contact lens care solutions were examined in vitro by colorimetric assay, based on the oxido-reduction of AlamarBlue. The cytotoxicity assays were performed using a fibroblast HS-5 (ATCC CRL-11882) cell line. The results were statistically analyzed by ANOVA and Student-Newman-Keuls tests using the p<0.05 level of a statistical significance.Results: The obtained results showed that nanoparticles enhanced anti-Acanthamoeba activity of the tested contact lens solutions without increasing their cytotoxicity profile. The activity is enhanced within minimal disinfection time recommended by the manufacturer.Conclusions: The conjugation of the selected contact lens solutions with AgTANPs might be a novel and promising approach as a part of preventive actions of Acanthamoeba keratitis infections among contact lens users.


2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Ahmed Sohail ◽  
Zain Ul Abideen ◽  
Fatima Zahid ◽  
Wahid Bakhsh

Purpose:  To determine the awareness regarding contact lens related ocular complications among opticians of Lahore and to find out the relationship between the awareness and their educational qualification. Study Design:  Cross sectional survey. Place and duration of Study: University of Lahore from April 2020- December 2020. Methods:  This survey included opticians of different areas of Lahore, Pakistan. Two hundred and eleven opticians responded to a pre-tested, structured close ended questionnaire. Data comprised of demographics and contact lens selling experience. Information regarding awareness about contact lens related complications was also sought. The data were analyzed using SPSS 25.0. Results:  A total of 211 opticians participated in the survey. All subjects were males. Fifty four (25.6%) subjects were from the age group of 15 to 30 years, 122 (57.8%) were from the age group of 31 to 45 and 35 (16.6%) were from the age group of 46 to 60 years. Only 4.7% had contact lens dispensing diploma. Thirty seven percent patients had contact lens selling experience of 2 to 10 years. Similar percentage had more than 10 years of experience. Ten percent had less than one year of experience. Only 54 participants out of 211 had knowledge about dry eye, 9 knew about Acanthamoeba keratitis and Bacterial keratitis and only 2 were aware of corneal opacity. Conclusion:  Majority of the opticians of Lahore are unaware of the contact lenses related complications. Sale of cosmetic lenses for fashion purpose should be discouraged and banned if not prescribed by optometrist/ ophthalmologist. Key Words:  Opticians, Contact lenses, Bacterial Keratitis.


2020 ◽  
Vol 5 (1) ◽  
pp. e000476
Author(s):  
Anna Stellwagen ◽  
Cheryl MacGregor ◽  
Roger Kung ◽  
Aristides Konstantopoulos ◽  
Parwez Hossain

ObjectiveMicrobial keratitis is a sight-threatening complication of contact lens wear, which affects thousands of patients and causes a significant burden on healthcare services. This study aims to identify compliance with contact lens care recommendations and identify personal hygiene risk factors in patients who develop contact lens-related microbial keratitis.Methods and analysisA case–control study was conducted at the University Hospital Southampton Eye Casualty from October to December 2015. Two participant groups were recruited: cases were contact lens wearers presenting with microbial keratitis and controls were contact lens wearers without infection. Participants underwent face-to-face interviews to identify lens wear practices, including lens type, hours of wear, personal hygiene and sleeping and showering in lenses. Univariate and multivariate regression models were used to compare groups.Results37 cases and 41 controls were identified. Showering in contact lenses was identified as the greatest risk factor (OR, 3.1; 95% CI, 1.2 to 8.5; p=0.03), with showering daily in lenses compared with never, increasing the risk of microbial keratitis by over seven times (OR, 7.1; 95% CI, 2.1 to 24.6; p=0.002). Other risks included sleeping in lenses (OR, 3.1; 95% CI, 1.1 to 8.6; p=0.026), and being aged 25–39 (OR, 6.38; 95% CI, 1.56 to 26.10; p=0.010) and 40–54 (OR, 4.00; 95% CI 0.96 to 16.61; p=0.056).ConclusionThe greatest personal hygiene risk factor for contact lens-related microbial keratitis was showering while wearing lenses, with an OR of 3.1, which increased to 7.1 if patients showered daily in lenses. The OR for sleeping in lenses was 3.1, and the most at-risk age group was 25–54.


2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Vishnu Raghuram ◽  
Joanna B. Goldberg

Pseudomonas aeruginosa is the major cause of bacterial keratitis, a sight-threatening ocular infection that can occur in contact lens wearers, as well as in others. Here, we report the draft genomes of 8 different P. aeruginosa corneal isolates, adding to the list of publicly available corneal infection-associated P. aeruginosa genomes.


2013 ◽  
Vol 36 ◽  
pp. e41
Author(s):  
Lakshman Subbaraman ◽  
Hendrik Walther ◽  
Lise Kay ◽  
Lyndon Jones

2011 ◽  
Vol 55 (11) ◽  
pp. 5134-5142 ◽  
Author(s):  
Phillip J. Bergen ◽  
Alan Forrest ◽  
Jürgen B. Bulitta ◽  
Brian T. Tsuji ◽  
Hanna E. Sidjabat ◽  
...  

ABSTRACTThe use of combination antibiotic therapy may be beneficial against rapidly emerging resistance inPseudomonas aeruginosa. The aim of this study was to systematically investigatein vitrobacterial killing and resistance emergence with colistin alone and in combination with imipenem against multidrug-resistant (MDR)P. aeruginosa. Time-kill studies were conducted over 48 h using 5 clinical isolates and ATCC 27853 at two inocula (∼106and ∼108CFU/ml); MDR, non-MDR, and colistin-heteroresistant and -resistant strains were included. Nine colistin-imipenem combinations were investigated. Microbiological response was examined by log changes at 6, 24, and 48 h. Colistin combined with imipenem at clinically relevant concentrations increased the levels of killing of MDR and colistin-heteroresistant isolates at both inocula. Substantial improvements in activity with combinations were observed across 48 h with all colistin concentrations at the low inoculum and with colistin at 4× and 16× MIC (or 4 and 32 mg/liter) at the high inoculum. Combinations were additive or synergistic against imipenem-resistant isolates (MICs, 16 and 32 mg/liter) at the 106-CFU inoculum in 9, 11, and 12 of 18 cases (i.e., 9 combinations across 2 isolates) at 6, 24, and 48 h, respectively, and against the same isolates at the 108-CFU inoculum in 11, 7, and 8 cases, respectively. Against a colistin-resistant strain (MIC, 128 mg/liter), combinations were additive or synergistic in 9 and 8 of 9 cases at 24 h at the 106- and 108-CFU inocula, respectively, and in 5 and 7 cases at 48 h. This systematic study provides important information for optimization of colistin-imipenem combinations targeting both colistin-susceptible and colistin-resistant subpopulations.


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