Microbial Bioburden of Orthokeratology Contact Lens Care System

Objective: To assess the bioburden in an orthokeratology contact lens (OK) care system (defined by microbial identification from OK case fluid) and to identify the risk factors causing high bioburden for pediatric OK wearers in southern Taiwan. Methods: A prospective study for the investigation of bioburden in the OK care system was performed in a tertiary medical center in southern Taiwan. Microbial isolates from the case fluids soaking OKs were analyzed, and pathogenicity was determined. Age, gender, OK experiences, and contact lens care habits were considered the potential risk factors of microbial bioburden (colony-forming units per milliliter) for causal analysis. Results: Forty-one OK wearers (20 female and 21 male subjects) participated in this study. The mean age was 12.7 years, and the mean OK-wearing experience was 3.5 years. A total of 86 microbial strains were isolated from 38 culture-positive specimens. Frequently reported pathogens in contact lens–related microbial keratitis were less common in the current study, but still present, including 4 strains (5%) of Serratia marcescens, 1 strain (1%) of Pseudomonas aeruginosa, and 1 strain (1%) of Staphylococcus aureus. Microbial bioburden of the OK care system was significantly higher (P<0.05) in male subjects. Conclusions: The contamination rate of the OK care system was high, and many isolated microorganisms had potential pathogenicity. Reinforcement of proper contact lens care and education should be mandatory for OK wearers, particularly for male subjects, to decrease the risk of high bioburden of the OK care system.

[1]  V. Jhanji,et al.  Orthokeratology-associated infectious keratitis in a tertiary care eye hospital in Hong Kong. , 2014, American journal of ophthalmology.

[2]  Hung-Chi Chen,et al.  Pediatric microbial keratitis in Taiwan: clinical and microbiological profiles, 1998-2002 versus 2008-2012. , 2014, American journal of ophthalmology.

[3]  T. Kuzman,et al.  Lens wearers non-compliance - is there an association with lens case contamination? , 2014, Contact lens & anterior eye : the journal of the British Contact Lens Association.

[4]  Savitri Sharma,et al.  Microbial Analyses of Contact Lens–Associated Microbial Keratitis , 2014, Optometry and vision science : official publication of the American Academy of Optometry.

[5]  A. Geerards,et al.  Clinical presentation and morbidity of contact lens–associated microbial keratitis: a retrospective study , 2014, Graefe's Archive for Clinical and Experimental Ophthalmology.

[6]  M. Nikolic,et al.  Identification and susceptibility to multipurpose disinfectant solutions of bacteria isolated from contact lens storage cases of patients with corneal infiltrative events. , 2013, Contact lens & anterior eye : the journal of the British Contact Lens Association.

[7]  V. Jhanji,et al.  Risk factors, microbiological profile, and treatment outcomes of pediatric microbial keratitis in a tertiary care hospital in Hong Kong. , 2013, American journal of ophthalmology.

[8]  M. Bullimore,et al.  The Risk of Microbial Keratitis With Overnight Corneal Reshaping Lenses , 2013, Optometry and vision science : official publication of the American Academy of Optometry.

[9]  Fabio Lavinsky,et al.  Clinical characteristics and outcomes of patients admitted with presumed microbial keratitis to a tertiary medical center in Israel. , 2013, Arquivos brasileiros de oftalmologia.

[10]  M. Ray,et al.  A Rare Polymicrobial Keratitis Involving Chryseobacterium meningosepticum and Delftia acidovorans in a Cosmetic Contact Lens Wearer , 2013, Eye & contact lens.

[11]  D. Glidden,et al.  Fluoroquinolone treatment and susceptibility of isolates from bacterial keratitis. , 2013, JAMA ophthalmology.

[12]  P. Cho,et al.  Comparison of Contamination Rates of Designs of Rigid Contact Lens Cases , 2012, Optometry and Vision Science.

[13]  T. Lai,et al.  Pediatric Ocular Surface Infections: A 5-year Review of Demographics, Clinical Features, Risk Factors, Microbiological Results, and Treatment , 2011, Cornea.

[14]  S. Yeung,et al.  Late-onset Klebsiella oxytoca flap-margin-related corneal ulcer following laser in situ keratomileusis. , 2011, Journal of cataract and refractive surgery.

[15]  P. Hossain,et al.  Geographic variations in microbial keratitis: an analysis of the peer-reviewed literature , 2011, British Journal of Ophthalmology.

[16]  H. D. Cavanagh,et al.  Patient Compliance During Contact Lens Wear: Perceptions, Awareness, and Behavior , 2010, Eye & contact lens.

[17]  Mahmoud Ghannoum,et al.  Microbial Contamination of Contact Lenses, Lens Care Solutions, and Their Accessories: A Literature Review , 2010, Eye & contact lens.

[18]  F. Stapleton,et al.  Profile and Frequency of Microbial Contamination of Contact Lens Cases , 2010, Optometry and vision science : official publication of the American Academy of Optometry.

[19]  P. Cho,et al.  Non-Compliance and Microbial Contamination in Orthokeratology , 2009, Optometry and vision science : official publication of the American Academy of Optometry.

[20]  S. Cheung,et al.  Orthokeratology practice in children in a university clinic in Hong Kong * , 2008, Clinical & experimental optometry.

[21]  F. Stapleton,et al.  Risk Factors and Causative Organisms in Microbial Keratitis , 2008, Cornea.

[22]  T. Naduvilath,et al.  Relationship between climate, disease severity, and causative organism for contact lens-associated microbial keratitis in Australia. , 2007, American journal of ophthalmology.

[23]  Yu-Chih Hou,et al.  Antibiotic susceptibility of bacterial isolates from bacterial keratitis cases in a university hospital in Taiwan. , 2007, American journal of ophthalmology.

[24]  H. Taylor,et al.  Association between cultures of contact lens and corneal scraping in contact lens related microbial keratitis. , 2007, Archives of ophthalmology.

[25]  L. Yeung,et al.  Pediatric microbial keratitis in Taiwanese children: a review of hospital cases. , 2007, Archives of ophthalmology.

[26]  P. Cho,et al.  Microbial contamination of contact lenses and lens care accessories of soft contact lens wearers (university students) in Hong Kong , 2007, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[27]  S. Stinnett,et al.  Analysis of bacterial cultures in infectious keratitis, 1997 to 2004. , 2006, American journal of ophthalmology.

[28]  P. Cho,et al.  Efficacy of multipurpose solutions for rigid gas permeable lenses , 2006, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[29]  Yu-Chih Hou,et al.  Overnight Orthokeratology-Associated Microbial Keratitis , 2005, Cornea.

[30]  P. Cho,et al.  Microbial Flora of Tears of Orthokeratology Patients, and Microbial Contamination of Contact Lenses and Contact Lens Accessories , 2005, Optometry and vision science : official publication of the American Academy of Optometry.

[31]  M. Edwards,et al.  The Longitudinal Orthokeratology Research in Children (LORIC) in Hong Kong: A Pilot Study on Refractive Changes and Myopic Control , 2005, Current eye research.

[32]  E. Donnenfeld,et al.  Chryseobacterium meningosepticum keratitis. , 2003, American journal of ophthalmology.

[33]  D C Minassian,et al.  Acanthamoeba keratitis in England and Wales: incidence, outcome, and risk factors , 2002, The British journal of ophthalmology.

[34]  A. Graham,et al.  Impact of rigid gas-permeable contact lens extended wear on corneal epithelial barrier function. , 2002, Investigative ophthalmology & visual science.

[35]  B. Chou,et al.  (CL-118)MANAGING LASIK-INDUCED IRREGULAR ASTIGMATISM WITH SOFT CONTACTS: Poster # 42 , 2000 .

[36]  Matthew M. Marsich,et al.  Overnight Orthokeratology: Refractive and Corneal Recovery After Discontinuation of Reverse-Geometry Lenses , 2004, Eye & contact lens.

[37]  H. D. Cavanagh,et al.  The relationship between contact lens oxygen permeability and binding of Pseudomonas aeruginosa to human corneal epithelial cells after overnight and extended wear. , 1999, The CLAO journal : official publication of the Contact Lens Association of Ophthalmologists, Inc.

[38]  Stapleton,et al.  Bacterial biofilm on contact lenses and lens storage cases in wearers with microbial keratitis , 1998, Journal of applied microbiology.

[39]  B. J. Clark,et al.  Microbial contamination of contact lens cases in the west of Scotland. , 1993, The British journal of ophthalmology.

[40]  M. Rupp,et al.  Colonization of the female genital tract with Staphylococcus saprophyticus , 1992, Journal of clinical microbiology.

[41]  L. Wilson,et al.  Adherence of Pseudomonas aeruginosa to rigid gas-permeable contact lenses. , 1991, Archives of ophthalmology.

[42]  F. Stapleton,et al.  Contact lenses and other risk factors in microbial keratitis , 1991, The Lancet.

[43]  G. Woo,et al.  Current methods of treating and preventing myopia. , 1990, Optometry and Vision Science.

[44]  E. C. Poggio,et al.  The incidence of ulcerative keratitis among users of daily-wear and extended-wear soft contact lenses. , 1989, The New England journal of medicine.

[45]  G. Visvesvara,et al.  The epidemiology of Acanthamoeba keratitis in the United States. , 1989, American journal of ophthalmology.