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Hernández-Martínez D, Castro Pot E, Hernández Olmos P, Guzmán Hernández EA, Cobos DS, Villa Ramírez S, Villamar Duque TE, Durán Díaz Á, Omaña-Molina M. Acanthamoeba castellanii trophozoites that survive multipurpose solutions are able to adhere to cosmetic contact lenses, increasing the risk of infection. Heliyon 2023; 9:e19599. [PMID: 37809484 PMCID: PMC10558846 DOI: 10.1016/j.heliyon.2023.e19599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 08/14/2023] [Accepted: 08/28/2023] [Indexed: 10/10/2023] Open
Abstract
Amoebae of the genus Acanthamoeba are etiological agents of amoebic keratitis, for which up to now there is no treatment of choice and one of its main risk factors is the use of contact lenses, including cosmetic contact lenses. Recently there has been an increase in amoebic keratitis cases due to the use of cosmetic contact lenses. Therefore, having a solution for the care of lenses with an efficient disinfectant effect that prevents the adhesion of trophozoites to lenses becomes essential. This study was carried out to determine the effect of 8 multipurpose contact lenses care solutions on Acanthamoeba castellanii trophozoites viability, and the efficiency of two of them to prevent the trophozoites adherence onto two cosmetic contact lenses (Acuvue 2, approved by the US Food and Drug Administration, and Magic Eye CCL, not approved). After 3 h of interaction, only AO Sept Plus, OPTI FREE Replenish, Renu Plus, Bio True and Multiplus significantly reduced the number of viable trophozoites with respect to the control; at 6 h Renu Plus, and at 12 h Conta Soft Plus and Multiplus, maintained the inhibitory effect. Only Opti Free Pure Moist did not significantly reduce the number of viable trophozoites. Multiplus and Opti Free Pure Moist (selected for their greater and lesser antiamibic effect) significantly reduced trophozoite adherence to both lenses; however, Opti Free Pure Moist was more efficient, despite the fact that A. castellanii adhered similarly to both lenses. Our results show that in all the multipurpose solutions evaluated, hundreds of viable A. castellanii trophozoites remain after several hours of incubation. Therefore, storage of the lenses in their case with MPS maintains the potential risk of amoebic keratitis in, cosmetic contact lenses wearers. Moreover, the use of CCL, not approved by the FDA, can increase the risk factor for AK since its poor manufacture can favor the permanence of amoebae, in addition to being a risk for corneal integrity.
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Affiliation(s)
- Dolores Hernández-Martínez
- Carrera de Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, Mexico
| | - Edson Castro Pot
- Carrera de Optometría, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, Mexico
| | - Perla Hernández Olmos
- Carrera de Optometría, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, Mexico
| | | | - David Segura Cobos
- Carrera de Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, Mexico
| | - Sandra Villa Ramírez
- Carrera de Optometría, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, Mexico
| | - Tomás Ernesto Villamar Duque
- Carrera de Biología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, Mexico
| | - Ángel Durán Díaz
- Carrera de Biología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, Mexico
| | - Maritza Omaña-Molina
- Carrera de Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, Mexico
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Bruce AS, Nguyen LM. Acute red eye (non‐ulcerative keratitis) associated with mini‐scleral contact lens wear for keratoconus. Clin Exp Optom 2021; 96:245-8. [DOI: 10.1111/cxo.12033] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Accepted: 11/29/2012] [Indexed: 11/27/2022] Open
Affiliation(s)
- Adrian S Bruce
- Australian College of Optometry, Carlton, Victoria, Australia,
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia,
| | - Leanne M Nguyen
- Australian College of Optometry, Carlton, Victoria, Australia,
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Mohd Hussain RH, Afiqah WN, Abdul Ghani MK, Khan NA, Siddiqui R, Anuar TS. In vitro effects of multi-purpose contact lens disinfecting solutions towards survivability of Acanthamoeba genotype T4 in Malaysia. Saudi J Biol Sci 2021; 28:2352-2359. [PMID: 33911949 PMCID: PMC8071914 DOI: 10.1016/j.sjbs.2021.01.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 12/05/2022] Open
Abstract
The incidence of Acanthamoeba keratitis has been increasing since the previous decades, especially among contact lens users. This infection is majorly caused by the use of ineffective contact lens disinfecting solution. Thus, this study was conducted to evaluate the in vitro effects of multi-purpose disinfecting solutions (MPDS) against Acanthamoeba trophozoites and cysts. Acanthamoeba genotype T4 isolated from contact lens paraphernalia and an environmental strains were propagated for trophozoite or cyst-containing culture and adjusted in final concentration of 1 × 105 cells/ml. Amoebicidal and cysticidal assays were conducted by incubating trophozoites and cysts with OPTI-FREE® Express®, ReNu® Fresh™, Complete® Multi-Purpose Solution and AVIZOR Unica® Sensitive according to the manufacturer’s minimum recommended disinfectant time (MMRDT) for up to 12 h at 30 ⁰C. Trypan blue hemocytometer-based microscopic counts determined amoebicidal and cysticidal effects. The viability of Acanthamoeba trophozoites and cysts was confirmed by re-inoculated them in the 1.5% non-nutrient agar plates. It was found that none of the MPDS showed amoebicidal and cysticidal effects during the MMRDT. However, OPTI-FREE® Express® demonstrated a significant differences in average cell reduction for both stages within MMRDT. When subjected to 12 h exposure, both OPTI-FREE® Express® and ReNu® Fresh™ led to significant reduction in the number of trophozoite and cyst cells. Notably, Complete® Multi-Purpose Solution and AVIZOR Unica® Sensitive did appreciably improve the solution effectiveness towards trophozoite cells when incubated for 12 h. All MPDS were largely ineffective, with 100% survival of all isolates at MMRDT, while OPTI-FREE® Express® showed limited amoebicidal activity against the contact lens paraphernalia isolate, however, it was more against the environmental strains after 12 h incubation time. The commercially available MPDS employed in this research offered minimal effectiveness against the protozoa despite the contact time. Improvement or development of new solution should consider the adjustment of the appropriate disinfectant concentration, adequate exposure time or the incorporation of novel chemical elements, which are effective against Acanthamoeba for accelerated disinfecting and more reduction of potential exposure of contact lens users to Acanthamoeba keratitis.
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Affiliation(s)
- Rosnani Hanim Mohd Hussain
- Centre of Medical Laboratory Technology, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam Campus, Selangor, Malaysia
| | - Wan Nur Afiqah
- Centre of Medical Laboratory Technology, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam Campus, Selangor, Malaysia
| | - Mohamed Kamel Abdul Ghani
- Programme of Biomedical Sciences, School of Diagnostic and Applied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Naveed Ahmed Khan
- Department of Clinical Sciences, College of Medicine, University of Sharjah, University City, Sharjah, United Arab Emirates
| | - Ruqaiyyah Siddiqui
- Department of Biology, Chemistry and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, University City, Sharjah, United Arab Emirates
| | - Tengku Shahrul Anuar
- Centre of Medical Laboratory Technology, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam Campus, Selangor, Malaysia.,Integrative Pharmacogenomics Institute, Universiti Teknologi MARA, Puncak Alam Campus, Selangor, Malaysia
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Cho P, Reyes S, Boost M. Microbiocidal characterization of a novel povidone-iodine based rigid contact lens disinfecting solution. Cont Lens Anterior Eye 2018; 41:542-546. [DOI: 10.1016/j.clae.2018.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/02/2018] [Accepted: 08/02/2018] [Indexed: 01/09/2023]
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Fears AC, Metzinger RC, Killeen SZ, Reimers RS, Roy CJ. Comparative in vitro effectiveness of a novel contact lens multipurpose solution on Acanthamoeba castellanii. J Ophthalmic Inflamm Infect 2018; 8:19. [PMID: 30357549 PMCID: PMC6200833 DOI: 10.1186/s12348-018-0161-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 10/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A multipurpose contact lens cleaning solution (MPS) containing novel active ingredients under development was compared to two commercially available MPS solutions for effectiveness against Acanthamoeba isolates. METHODS The Acanthamoeba isolate A. castellanii was propagated for trophozoite or cyst-containing cultures for the purpose of assessment of effectiveness of each MPS. An alamar blue-based cellular respiration assay was used to assess effectiveness against trophozoites; Trypan blue hemocytometer-based microscopic counts measured cysticidal effects. To assess the general antimicrobial potency of each solution as controls for the anti-amoebic assays, comparative bactericidal effectiveness using Serratia marcenses was also performed. RESULTS Minimal effectiveness against either Acanthamoeba form was observed from either commercial MPS. In contrast, the novel MPS achieved complete kill within 1 h contact time for both Acanthamoeba trophozoite and cysts. Each commercial MPS required 6 h contact time to achieve a two to three log reduction in S. marcenses. In contrast, the experimental MPS achieved disinfection in 60 min contact time, and complete kill (< 1 CFU) at 90 min. CONCLUSIONS Results suggest that the inclusion of a novel ingredient combination within the MPS under development clearly is required and is ideal for rapid and effective killing of Acanthamoeba species in the context of contact lens disinfection systems. The representative commercially available MPS used in this testing provided minimal effectiveness against the protozoa regardless of contact time. In addition, comparative results with the bacterial agent in the control study show distinct differences in the speed to disinfection with the novel MPS. Future MPS development should consider inclusion of novel chemical entities that are effective against Acanthamoeba species to speed disinfection and further reduce the exposure potential of users of contact lenses and cleaning systems.
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Affiliation(s)
- Alyssa C Fears
- Department of Microbiology and Immunology, Tulane School of Medicine, New Orleans, LA, 70102, USA
| | - Rebecca C Metzinger
- Department of Ophthalmology, Tulane University School of Medicine, New Orleans, LA, 70102, USA
| | - Stephanie Z Killeen
- Division of Microbiology, Tulane National Primate Research Center, Covington, LA, 70433, USA
| | - Robert S Reimers
- Department of Environmental Health Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, 70102, USA
| | - Chad J Roy
- Department of Microbiology and Immunology, Tulane School of Medicine, New Orleans, LA, 70102, USA. .,Division of Microbiology, Tulane National Primate Research Center, Covington, LA, 70433, USA.
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Mahittikorn A, Kittichathanakul T, To-Im J, Nacapunchai D. Knowledge, Behavior, and Free-Living Amoebae Contamination of Cosmetic Contact Lens Among University Wearers in Thailand: A Cross-Sectional Study. Eye Contact Lens 2017; 43:81-8. [PMID: 26925535 DOI: 10.1097/ICL.0000000000000246] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the general knowledge, behavior, and presence of potentially pathogenic amoebae in cosmetic contact lens (CCL) wearers. METHODS One hundred CCL asymptomatic wearers were randomly selected. A questionnaire regarding their lens use, and a pair of their CCL was obtained. Identification of free-living amoeba (FLA) strains was based on morphological diagnosis, enflagellation tests (for non-Acanthamoeba strains), and sequencing of the small-subunit rRNA gene fragments. RESULTS Most (92%) of the participants surveyed were women, and the average age of the participants was 21.5±0.2 years. The CCL wearers generally showed a moderate (47%) or good (35%) level of knowledge, and good (51%) or excellent (40%) use of CCL. Two CCL samples were positive for Acanthamoeba genotype T3 or Vahlkampfia. The Acanthamoeba-contaminated CCL was from a wearer who used saline for treating lenses, and the Vahlkampfia-contaminated CCL was from a wearer who used CCL while swimming. CONCLUSIONS This is the first report of the presence of potentially pathogenic FLA in used CCL from asymptomatic wearers in Thailand. Although there was satisfactory knowledge and practice of lens care use, the public should be aware of CCL contaminated with potentially pathogenic FLA that can directly or indirectly cause keratitis.
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Davis SC, Harding A, Gil J, Parajon F, Valdes J, Solis M, Higa A. Effectiveness of a polyhexanide irrigation solution on methicillin-resistant Staphylococcus aureus biofilms in a porcine wound model. Int Wound J 2017; 14:937-944. [PMID: 28266133 DOI: 10.1111/iwj.12734] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 02/01/2017] [Accepted: 02/10/2017] [Indexed: 01/22/2023] Open
Abstract
Irrigation and removal of necrotic debris can be beneficial for proper healing. It is becoming increasingly evident that wounds colonized with biofilm forming bacteria, such as Staphylococcus aureus (SA), can be more difficult to eradicate. Here we report our findings of the effects of an irrigation solution containing propyl-betaine and polyhexanide (PHMB) on methicillin-resistant Staphylococcus aureus (MRSA) biofilms in a porcine wound model. Thirty-nine deep partial thickness wounds were created with six wounds assigned to one of six treatment groups: (i) PHMB, (ii) Ringer's solution, (iii) hypochlorous acid/sodium hypochlorite, (iv) sterile water, (v) octenidine dihydrochloride, and (vi) octenilin. Wounds were inoculated with MRSA and covered with a polyurethane dressing for 24 hours to allow biofilm formation. The dressings were then removed and the wounds were irrigated twice daily for 3 days with the appropriate solution. MRSA from four wounds were recovered from each treatment group at 3 days and 6 days hours after initial treatment. Irrigation of wounds with the PHMB solution resulted in 97·85% and 99·64% reductions of MRSA at the respective 3 days and 6 days assessment times when compared to the untreated group. Both of these reductions were statistically significant compared to all other treatment groups (P values <0·05).
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Affiliation(s)
- Stephen C Davis
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Andrew Harding
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Joel Gil
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Fernando Parajon
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jose Valdes
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Michael Solis
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Alex Higa
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
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Lee GH, Yu HS, Lee JE. Effects of multipurpose solutions on the adhesion ofAcanthamoebato rigid gas permeable contact lenses. Ophthalmic Physiol Opt 2016; 36:93-9. [DOI: 10.1111/opo.12277] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 01/05/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Ga-Hyun Lee
- Department of Cellular and Molecular Biology; California State University; Chico CA USA
| | - Hak-Sun Yu
- Department of Parasitology; Pusan National University College of Medicine; Yangsan Korea
| | - Ji-Eun Lee
- Department of Ophthalmology; Pusan National University College of Medicine; Yangsan Korea
- Research Institute for Convergence of Biomedical Science and Technology; Pusan National University Yangsan Hospital; Yangsan Korea
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Abstract
PURPOSE To assess and compare the antifungal activity of polyhexamethylene biguanide (PHMB), thimerosal, cetylpyridinium chloride, and chlorhexidine, which are disinfectants used in multipurpose disinfectant solutions (MPDSs) against ocular pathogenic Fusarium solani and Aspergillus flavus isolates in vitro. METHODS The in vitro activity of PHMB, thimerosal, cetylpyridinium chloride, and chlorhexidine was assessed against 40 isolates of ocular pathogenic fungi that included 24 F. solani and 16 A. flavus isolates. The strains were tested by broth dilution antifungal susceptibility testing of filamentous fungi approved by the CLSI (Clinical and Laboratory Standards Institute) M38-A document. RESULTS MIC90 (minimum inhibitory concentration for 90% of the organisms) values of PHMB were 4 and 16 μg/mL for F. solani and A. flavus, respectively. MIC90 values of thimerosal were 0.0313 and 0.0625 μg/mL for F. solani and A. flavus, respectively. MIC90 values of cetylpyridinium chloride were 2 and 2 μg/mL for F. solani and A. flavus, respectively. MIC90 values of chlorhexidine were 32 and 32 μg/mL for F. solani and A. flavus, respectively. CONCLUSIONS As a disinfectant used in MPDSs, thimerosal showed the highest levels of antimicrobial activity against ocular pathogenic F. solani and A. flavus isolates. The concentrations of PHMB (0.0001%), cetylpyridinium chloride (0.00014%), and chlorhexidine (0.003%) in MPDSs are sublethal levels for ocular pathogenic F. solani and A. flavus isolates. Although multiple ingredients within MPDSs play a role in antimicrobial efficacy, antimicrobial activity may be significantly influenced by the disinfectants used in the solution formulations.
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Ustüntürk M, Zeybek Z. Amoebicidal efficacy of a novel multi-purpose disinfecting solution: first findings. Exp Parasitol 2014; 145 Suppl:S93-7. [PMID: 24858922 DOI: 10.1016/j.exppara.2014.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 05/12/2014] [Accepted: 05/13/2014] [Indexed: 11/24/2022]
Abstract
Free-living amoebae of the genus Acanthamoeba can cause a sight-threatening corneal infection, Acanthamoeba keratitis, mostly in contact lens wearers. The use of ineffective contact lens disinfecting solutions is one of the most important risk factors for this infection. This study concerns a new multi-purpose contact lens disinfecting solution, OPTI-FREE® PureMoist®, tested for its efficacy against Acanthamoeba trophozoites and cysts by using the most probable number technique for amoebic enumeration. Acanthamoeba castellanii ATCC 50373 and an environmental strain of Acanthamoeba genotype T4 isolated from tap water in Istanbul were used during the experiments. OPTI-FREE® PureMoist® achieved total kill (more than a 3-log reduction) of trophozoites of both strains before the manufacturer-recommended disinfection time (6h). In contrast, this solution had limited cysticidal activity against the ATCC strain but more against the environmental strain, with log reductions of 0.75 and 2.20, respectively, after 6h of exposure.
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Abstract
PURPOSE To compare the traditional manual hemacytometer method and an automated counter (Vi-cell) to enumerate and distinguish between viable and non-viable amoeba, and to determine the efficacies of contact lens (CL) disinfecting solutions against three species of Acanthamoeba. The efficacies in the presence of a bacterial food source and bovine serum albumin (BSA) were investigated. METHODS Four brands of multipurpose solutions and a hydrogen peroxide disinfecting system (Oxysept) for soft CLs, and four disinfecting solutions for Rigid Gas Permeable (RGP) lenses were tested against three species of Acanthamoeba. Page's amoebic saline was included as a negative control and standard solutions of disinfecting agents, 6% hydrogen peroxide and 0.5% chlorhexidine, as positive controls. The effects of the presence of Pseudomonas aeruginosa and BSA on effectiveness were assessed. RESULTS None of the CL solutions tested achieved a 1-log reduction in viability of all three Acanthamoeba species within the manufacturer's recommended disinfection times. The presence of P. aeruginosa did not significantly affect disinfecting capacity of multipurpose solution solutions but reduced activity of RGP solutions and the hydrogen peroxide system. BSA reduced trophozoicidal activity of all solutions. Bland and Altman analysis showed good agreement between Vi-cell and hemacytometer. CONCLUSIONS The Vi-Cell analyzer offers a simple and effective method of determining amoebicidal activity. Our results show that the CL solutions tested could not satisfactorily kill Acanthamoeba.
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Laummaunwai P, Ruangjirachuporn W, Boonmars T. A simple PCR condition for detection of a single cyst of Acanthamoeba species. Parasitol Res 2011; 110:1569-72. [PMID: 21989579 DOI: 10.1007/s00436-011-2662-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 09/27/2011] [Indexed: 10/17/2022]
Abstract
Acanthamoeba is a free-living protozoan with a worldwide distribution in a variety of natural and artificial habitats. It has even been found in contact lens solution. Acanthamoeba spp. can cause infections such as granulomatous amoebic encephalitis and amoebic keratitis. Specific and sensitive diagnosis of Acanthamoeba infections can prevent clinical symptoms from worsening. Recently, PCR technique has been used for Acanthamoeba diagnosis. Unfortunately the dormant cyst of Acanthamoeba is resistant to chemical reagents; thus, most extraction of DNA uses a commercial DNA extraction kit for obtaining DNA for further use in polymerase chain reaction (PCR). Therefore in the present study, we improved the ability to diagnose Acanthamoeba using a simplified PCR technique. Interestingly, heating at 94°C for 10 min could release DNA which is amplified with specific primers designed from 16S rRNA. The PCR product is about 180 bp. This technique is a simple and efficient method for detection of Acanthamoeba-even a single cyst-and does not require high-cost reagents or complicated procedures to extract DNA.
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Affiliation(s)
- Porntip Laummaunwai
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
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Chew HF, Yildiz EH, Hammersmith KM, Eagle RC Jr, Rapuano CJ, Laibson PR, Ayres BD, Jin YP, Cohen EJ. Clinical outcomes and prognostic factors associated with acanthamoeba keratitis. Cornea 2011; 30:435-41. [PMID: 21045665 DOI: 10.1097/ICO.0b013e3181ec905f] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe the clinical characteristics, time of presentation, risk factors, treatment, outcomes, and prognostic factors on a recent series of Acanthamoeba keratitis (AK) treated at our institution. METHODS Retrospective case series of 59 patients diagnosed with AK from January 1, 2004 to December 31, 2008. Of these 59 patients, 51 had complete follow-up data and were analyzed using univariate and multivariate logistic regression analyses performed with "failure" defined as requiring a penetrating keratoplasty (PKP) and/or having (1) best-corrected visual acuity (BCVA) < 20/100 or (2) BCVA < 20/25 at the last follow-up. A single multivariate model incorporating age, sex, steroid use before diagnosis, time to diagnosis, initial visual acuity (VA), stromal involvement, and diagnostic method was performed. RESULTS Symptom onset was greatest in the summer and lowest in the winter. With failure defined as requiring PKP and/or final BCVA < 20/100, univariate analysis suggests that age > 50 years, female sex, initial VA < 20/50, stromal involvement, and patients with a confirmed tissue diagnosis had a significant risk for failure; however, none of these variables were significant using multivariate analysis. Univariate analysis, with failure defined as requiring PKP and/or final BCVA < 20/25, showed stromal involvement and initial VA < 20/50 were significant for failure-only initial VA < 20/50 was significant using multivariate analysis. CONCLUSIONS Symptom onset for AK is greatest in the summer. Patients with confirmed tissue diagnosis and female patients may have a higher risk for failure, but a larger prospective population-based study is required to confirm this. Failure is likely associated with patients who present with stromal involvement and patients presenting with an initial BCVA worse than 20/50.
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Reindel W, Cairns G, Merchea M. Assessment of patient and practitioner satisfaction with Biotrue™ multi-purpose solution for contact lenses. Cont Lens Anterior Eye 2010; 33 Suppl 1:S12-7. [DOI: 10.1016/j.clae.2010.06.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Revised: 04/24/2010] [Accepted: 06/11/2010] [Indexed: 10/18/2022]
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Por YM, Mehta JS, Chua JLL, Koh TH, Khor WB, Fong ACY, Lim JWK, Heng WJ, Loh RSK, Lim L, Tan DTH. Acanthamoeba keratitis associated with contact lens wear in Singapore. Am J Ophthalmol 2009; 148:7-12.e2. [PMID: 19403109 DOI: 10.1016/j.ajo.2009.02.030] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2008] [Revised: 02/11/2009] [Accepted: 02/11/2009] [Indexed: 11/18/2022]
Abstract
PURPOSE To describe an outbreak of Acanthamoeba keratitis (AK) cases among contact lens wearers. DESIGN Retrospective cohort study. METHODS Patients with AK were included. Relevant demographic and clinical data were obtained from case records, and patients were interviewed using a standardized questionnaire. Contact lens practices, including type of contact lens and solution used, were noted. In addition, clinical features at presentation, management, and clinical outcomes were recorded. RESULTS Forty-two patients (affecting 43 eyes) treated between 2000 and 2007 were included. Diagnosis was made by microbiologic culture in 35 cases and by microbiologic and histologic analysis in 2 cases, whereas the remainder were diagnosed based on clinical features and response to treatment. There was a gradual increase in cases since 2005, with a sharp increase in 2007, when 8 local patients were treated. Of 30 patients where contact lens solution data were available, 18 reported using a Complete brand Multipurpose solution (Advanced Medical Optics, Santa Ana, California, USA) before the infection. Among resident cases treated since February 2006, 7 (63%) of 11 patients used a Complete brand solution. Suboptimal hygiene practices were found in all patients interviewed. Fifteen patients required corneal grafting, with 11 undergoing therapeutic deep lamellar keratoplasty (DLK), 2 undergoing optical penetrating keratoplasty (PK), 1 undergoing optical DLK, and 1 undergoing therapeutic PK. The remainder were treated successfully medically with combination antiamebic therapy. The average duration of therapy was 116.2 days (range, 15 to 283 days). Of patients with radial keratoneuritis with or without epithelial disease, 83.3% achieved final vision of 20/40 or better, whereas this was achieved in 41.7% of those with ring infiltrate. Twenty-five percent of patients with ring infiltrate had final visual acuity of counting fingers or worse, whereas no patient with keratoneuritis and epithelial disease had final vision worse than counting fingers. CONCLUSIONS There was an increase in the number of contact lens users with AK seen in the major eye departments of Singapore. Most of our patients also reported using a Complete brand Multipurpose solution before infection, and this parallels a similar outbreak in the United States. Increasing severity of infection was associated with worse visual outcome.
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Affiliation(s)
- Yong Ming Por
- Singapore National Eye Centre, Singapore, Republic of Singapore
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Walochnik J, Obwaller A, Gruber F, Mildner M, Tschachler E, Suchomel M, Duchene M, Auer H. Anti-Acanthamoeba efficacy and toxicity of miltefosine in an organotypic skin equivalent. J Antimicrob Chemother 2009; 64:539-45. [DOI: 10.1093/jac/dkp215] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
Recently, it was suggested that the use of the Advanced Medical Optics Complete MoisturePlus multipurpose cleaning solution might be a risk factor for contracting Acanthamoeba keratitis, and the manufacturer voluntarily recalled it in May 2007. Polymerase chain reaction amplification and sequencing of a variable part of the 18S rRNA gene allowed for the first time tracking of Advanced Medical Optics Complete MoisturePlus-associated Acanthamoeba keratitis isolate from a patient back to the lens cleaning solution itself.
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Joslin CE, Tu EY, Shoff ME, Booton GC, Fuerst PA, McMahon TT, Anderson RJ, Dworkin MS, Sugar J, Davis FG, Stayner LT. The association of contact lens solution use and Acanthamoeba keratitis. Am J Ophthalmol 2007; 144:169-180. [PMID: 17588524 PMCID: PMC2692658 DOI: 10.1016/j.ajo.2007.05.029] [Citation(s) in RCA: 187] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2007] [Revised: 05/25/2007] [Accepted: 05/28/2007] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate Acanthamoeba keratitis (AK) risk factors. Diagnosis of AK, a rare but serious corneal infection, has recently increased significantly at the University of Illinois at Chicago (UIC) Cornea Service. DESIGN Retrospective case-control study. METHODS settings: University, tertiary care hospital. patients: Fifty-five AK cases with contact lens use were diagnosed between May 1, 2003 and September 15, 2006. Clinic-matched controls with contact lens use were recruited. Subjects completed surveys targeting lens hygiene, contact lens solution use, and water exposure. main outcome measure: Acanthamoeba keratitis. 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 Advance Medical Optics (AMO) Complete MoisturePlus Multi-Purpose Solution was independently associated with AK in multivariable analysis (55.2% vs 10.5%; odds ratio [OR], 16.67; 95% confidence interval [CI] 2.11 to 162.63; P = .008). However, 38.8% of cases reported no use of AMO Complete MoisturePlus Multi-Purpose Solution either alone or 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 MoisturePlus Multi-Purpose Solution use is independently associated with AK among soft contact lens users. However, it does not explain all cases, suggesting additional factors. Further research into environmental risk factors and hygiene practices is warranted, especially considering this is the second outbreak of an atypical, contact lens-related infection.
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Affiliation(s)
- Charlotte E Joslin
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA.
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Abstract
PURPOSE To report a recent significant increase of the number of patients diagnosed with Acanthamoeba keratitis (AK) at Wills Eye Hospital between 2004 and 2005. To determine the risk factors, clinical characteristics, treatments, and outcomes of patients with AK. METHODS Retrospective consecutive case series of 20 eyes with AK. The information included the incidence from 1995 to 2005, initial and final best-corrected visual acuity (BCVA) at 3-month follow-up, risk factors [contact lenses (CL) history, history of swimming with CL, and exposure to well water and/or contaminated water], clinical characteristics, methods of diagnosis, and treatments. RESULTS A statistically significant increased incidence of AK was seen in 2004 and 2005 compared with cases from 1995 to 2003 (P < 0.01). All patients wore CL; 19 of 20 wore frequent-replacement soft CL and used multipurpose disinfecting solutions. Other risk factors were exposure to well water in 40%, swimming with CL in 25%, and overnight wear in 25%. The diagnosis was made by histopathology in 50%, by microbiology in 15%, and by initial classic clinical signs and response to treatments in 35%. Herpes simplex virus was the misdiagnosis in 70%. Patients who presented with dendritiform keratitis or radial keratoneuritis had a BCVA better than 20/30 in 8 of 9 (89%) and patients with ring ulcers or stromal disease who had a BCVA less than finger counting in 5 of 8 (62.5%). CONCLUSIONS We observed an increased incidence of AK. Patients with proper use of frequent-replacement CL and multipurpose solutions can develop AK. Advanced stromal disease at diagnosis is associated with worse outcome.
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Affiliation(s)
- Nuthida Thebpatiphat
- Cornea Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
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Polat ZA, Vural A, Cetin A. Efficacy of contact lens storage solutions against trophozoite and cyst of Acanthamoeba castellanii strain 1BU and their cytotoxic potential on corneal cells. Parasitol Res 2007; 101:997-1001. [PMID: 17514482 DOI: 10.1007/s00436-007-0576-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2007] [Accepted: 05/02/2007] [Indexed: 10/23/2022]
Abstract
Acanthamoeba is a free-living amoeba causing a potentially blinding infection of the cornea. Contact lens wearers are most at risk and account for about 95% of cases. We investigated the in vitro effectiveness of 10 contact lens solutions against Acanthamoeba castellanii and their cytotoxicity on corneal cells in vitro. Contact lens solutions were evaluated for their amoebicidal activities using an inverted light microscope. To determine of their cytotoxicity on corneal cells, agar diffusion tests were performed. According to the results obtained from the tests, AVIZOR Aqua Soft Comfort and Elegance(R) showed the best amoebicidal effect on A. castellanii trophozoites. Cysts were still viable after overnight (8 h) exposure. In the case of the cyctotoxic acitivities, All In One Light, Astek, SOLO-Care Aqua, Maxima, and Horien showed no cytotoxicity on the corneal cells. ReNu MultiPlus, AVIZOR Aqua Soft Comfort, Carrera, and Elegance showed mild cytotoxicity on the corneal cells. Plurisol.M presented moderate cytotoxicity on the corneal cells. All commercial solutions examined in this study are the lack of efficacy against A. castellanii. Improvement or development of new contact lens disinfecting systems by the manufacturers is needed to prevent Acanthamoeba keratitis.
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Affiliation(s)
- Zubeyde Akin Polat
- CUTFAM, Research Center, School of Medicine, Cumhuriyet University, 58140 Sivas, Turkey.
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Abstract
PURPOSE Acanthamoeba keratitis is a potentially blinding microbial disease that has been increasing in incidence during the past two decades. Prognosis of this serious disease had been dismal, but improvement in diagnosis, a better understanding of the natural course of the disease, and recent introduction of multiple and effective therapeutic agents have resulted in improvement of visual outcomes. METHODS A review of literature pertaining to Acanthamoeba keratitis. RESULTS Contact lens wear and exposure to contaminated water sources remain the most important risk factors; however, in vivo confocal microscopy and improved biomicroscopic screening have proven instrumental in accurate early diagnosis. Complications of Acanthamoeba keratitis include dacryoadenitis, corneal melting and scarring, severe secondary glaucoma, cataract, and chronic anterior segment inflammation that can rarely lead to reactive blinding retinal ischemia. Combination chemotherapeutic agents have been shown to be more effective than monotherapy, whereas rehabilitative surgery such as penetrating keratoplasty is best performed on a quiet eye free of ocular inflammation and with no residual amoebae. CONCLUSIONS Increased suspicion by clinicians for Acanthamoeba and confocal microscopy have allowed more rapid and accurate diagnosis; treatment with multiple antiamoeba drugs is essential to disease resolution. Provided there are no residual amoebae after treatment, penetrating keratoplasty has been successful in visual rehabilitation. Secondary glaucoma occurs frequently and may require drainage procedures for control of intraocular pressure. Posterior complications are rare but may lead to ischemic retinitis.
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Affiliation(s)
- Shady T Awwad
- Department of Ophthalmology, The University of Texas Southwestern Medical Center, Dallas, TX 75390-9057, USA
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