Document Detail

Risk factors for microbial bioburden during daily wear of silicone hydrogel contact lenses.
MedLine Citation:
PMID:  24756119     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: To assess risk factors associated with substantial microbial bioburden of lids, conjunctivae, contact lenses, and storage cases during daily wear of silicone hydrogel contact lenses.
METHODS: Two hundred eighteen patients were fit to lotrafilcon A lenses, randomized to use either a multipurpose solution or a hydrogen peroxide care system, and followed up for 1 year. Lenses, lens transport saline, lids, conjunctivae, and storage cases were cultured and considered to have substantial microbial bioburden when they harbored high levels of commensal or pathogenic organisms. Univariate and multivariate logistic regression analyses were conducted to examine which demographic covariates were associated with significant bioburden at each location while controlling for solution use.
RESULTS: In multivariate analyses, smoking trended toward an association with lens bioburden (odds ratio [OR]=2.15, 95% confidence interval [CI]: 0.95-4.88). Clerical occupations were found to be associated with more frequent overall storage case contamination (OR=3.51, 95% CI: 1.15-10.70) and, specifically, higher gram-positive storage case contamination (OR=5.57, 95% CI: 1.82-17.06). The peroxide system was associated with more frequent storage case contamination (OR=7.6, 95% CI: 3.79-15.19). Coagulase-negative staphylococci (CNS) were the most frequently cultured organisms within storage cases, and in multivariate analyses, CNS were more frequently found in storage cases of peroxide users (OR=6.12, 95% CI: 2.91-13.09).
CONCLUSIONS: Clerical occupations were associated with increased microbial bioburden of storage cases during daily wear of silicone hydrogel lenses. Smoking may increase the risk of lens contamination. Storage cases are most frequently contaminated with normal skin flora, and peroxide cases were associated with more frequent contamination. However, the solution type was not associated with lid or lens contamination nor with corneal infiltrative events in this study.
Ying Jiang; Michael Jacobs; Saralee Bajaksouzian; Altreisha N Foster; Sara M Debanne; Roger Bielefeld; Matt Garvey; Sangeetha Raghupathy; Jami Kern; Loretta B Szczotka-Flynn
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Eye & contact lens     Volume:  40     ISSN:  1542-233X     ISO Abbreviation:  Eye Contact Lens     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-04-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160941     Medline TA:  Eye Contact Lens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  148-56     Citation Subset:  IM    
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