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Schrenker B, Zimmermann A, Koch T, Walther G, Martin R, Kampik D, Kurzai O, Theuersbacher J. Polyhexanide based contact lens storage fluids frequently exhibit insufficient antifungal activity against Fusarium species. Int J Med Microbiol 2024; 314:151602. [PMID: 38280372 DOI: 10.1016/j.ijmm.2024.151602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/29/2024] Open
Abstract
PURPOSE Fusarium keratitis is a severe infection of the anterior eye, frequently leading to keratoplasty or surgical removal of the affected eye. A major risk factor for infection is the use of contact lenses. Inadequate hygiene precautions and mold-growth permissive storage fluids are important risk factors for fungal keratitis. The aim of this study was to comparatively analyze contact lens storage fluids disinfection efficacy against Fusarium species. METHODS Eleven commercially available storage fluids were tested. The storage fluids were classified according to their active ingredients myristamidopropyldimethylamine (Aldox), polyhexanide and hydrogen peroxide. Efficacy was tested against isolates belonging to the Fusarium solani and Fusarium oxysporum species complexes as the most common agents of mould keratitis. Tests were carried out based on DIN EN ISO 14729. RESULTS All Aldox and hydrogen peroxide (H2O2) based fluids were effective against Fusarium spp., while the majority of polyhexanide based storage fluids showed only limited or no antifungal effects. Efficacy of polyhexanide could be restored by the addition of the pH-regulating agent tromethamine - an additive component in one commercially available product. CONCLUSIONS In summary, the use of Aldox- or hydrogen peroxide-based storage fluids may reduce the risk of Fusarium keratitis, while polyhexanide-based agents largely lack efficacy against Fusarium.
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Affiliation(s)
- Benedikt Schrenker
- Institute for Hygiene and Microbiology, University of Würzburg, Germany; Department of Ophthalmology, University Hospital Würzburg, Germany
| | - Anna Zimmermann
- Institute for Hygiene and Microbiology, University of Würzburg, Germany
| | - Thorsten Koch
- Institute for Hygiene and Microbiology, University of Würzburg, Germany
| | - Grit Walther
- National Reference Center for Invasive Fungal Infections NRZMyk, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knoell Institute, Jena, Germany
| | - Ronny Martin
- Institute for Hygiene and Microbiology, University of Würzburg, Germany
| | - Daniel Kampik
- Department of Ophthalmology, University Hospital Würzburg, Germany
| | - Oliver Kurzai
- Institute for Hygiene and Microbiology, University of Würzburg, Germany; National Reference Center for Invasive Fungal Infections NRZMyk, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knoell Institute, Jena, Germany.
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Abstract
ABSTRACT Contact lenses are a safe and effective method for correction of refractive error and worn by an estimated 45 million Americans. Because of the widespread availability and commercial popularity of contact lenses, it is not well appreciated by the public that contact lenses are U.S. Food and Drug Administration (FDA)-regulated medical devices. Contact lenses are marketed in numerous hard and soft materials that have been improved over decades, worn in daily or extended wear, and replaced in range of schedules from daily to yearly or longer. Lens materials and wear and care regimens have impact on the risks of contact lens-related corneal inflammatory events and microbial keratitis. This article reviews contact lens safety, with specific focus on the correction of refractive error in healthy eyes.
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Moro A, Fagnola M, Picarazzi S, Di Dio A, Pastori V, Lecchi M, Tavazzi S. Hydrogen-peroxide and silicone-hydrogel contact lenses: Worsening of external eye condition and tear film instability. Cont Lens Anterior Eye 2017; 41:157-161. [PMID: 29066042 DOI: 10.1016/j.clae.2017.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 10/07/2017] [Accepted: 10/09/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim is discussing the origins of worsening of external eye condition (EEC) and of tear film (TF) instability after wear of silicone-hydrogel contact lenses (CLs) with hydrogen-peroxide (H2O2) care system. METHODS EEC and TF stability were evaluated before and after 15days of wear combined with different care systems: (1) H2O2, (2) detergent solution and H2O2, (3) multipurpose solution (MPS), (4) H2O2 and artificial tears. In-vitro cell mortality tests were performed after 24h cell incubation with CLs treated with H2O2. Photon correlation spectroscopy (PCS) was carried out on tears of non-wearers and CL wearers who used MPS or H2O2 solution. RESULTS Worsening of EEC was observed only for the group using H2O2 (group 1). In-vitro, cell mortality was found higher for worn CL than for unworn CLs. Worsening of TF stability was observed regardless of care system and also PCS results on tears of CL wearers were found different compared to non-wearers regardless of care system. The only observed remedy for tear instability of CL wearers was found to be the administration of artificial tears. CONCLUSIONS Worsening of EEC of CL wearers using H2O2 is attributed to H2O2 scarce cleaning efficacy, which can be solved by adding a CL detergent solution. The origin of TF instability is found to be different. A remedy was found to be the administration of artificial tears, whose effect could be attributed either to the role of specific components or to rinsing and replacement of TF during wear.
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Affiliation(s)
- A Moro
- Materials Science Department, University of Milano Bicocca, Via Cozzi 55, I-20125 Milan, Italy
| | - M Fagnola
- COMiB, University of Milano Bicocca, Via Cozzi 55, I-20125 Milan, Italy
| | - S Picarazzi
- Materials Science Department, University of Milano Bicocca, Via Cozzi 55, I-20125 Milan, Italy
| | - A Di Dio
- Materials Science Department, University of Milano Bicocca, Via Cozzi 55, I-20125 Milan, Italy
| | - V Pastori
- University of Milano Bicocca, Department of Biotechnology and Bioscience, Piazza della Scienza 2, I-20126 Milan, Italy; COMiB, University of Milano Bicocca, Via Cozzi 55, I-20125 Milan, Italy
| | - M Lecchi
- University of Milano Bicocca, Department of Biotechnology and Bioscience, Piazza della Scienza 2, I-20126 Milan, Italy; COMiB, University of Milano Bicocca, Via Cozzi 55, I-20125 Milan, Italy
| | - S Tavazzi
- Materials Science Department, University of Milano Bicocca, Via Cozzi 55, I-20125 Milan, Italy; COMiB, University of Milano Bicocca, Via Cozzi 55, I-20125 Milan, Italy.
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Bonferoni MC, Sandri G, Rossi S, Usai D, Liakos I, Garzoni A, Fiamma M, Zanetti S, Athanassiou A, Caramella C, Ferrari F. A novel ionic amphiphilic chitosan derivative as a stabilizer of nanoemulsions: Improvement of antimicrobial activity of Cymbopogon citratus essential oil. Colloids Surf B Biointerfaces 2017; 152:385-392. [PMID: 28152462 DOI: 10.1016/j.colsurfb.2017.01.043] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/20/2017] [Accepted: 01/23/2017] [Indexed: 11/15/2022]
Abstract
Amphiphilic chitosans have been recently proposed to improve delivery of poorly soluble drugs. In the present paper a derivative obtained by ionic interaction between chitosan and oleic acid was for the first time studied to physically stabilize o/w nanoemulsions of an antimicrobial essential oil, Cymbopogon citratus (Lemongrass), in a low energy and mild conditions emulsification process. The novel combination of spontaneous emulsification process with chitosan oleate amphiphilic properties resulted in a stable dispersion of a few hundred nanometer droplets. Positive zeta potential confirmed the presence of a chitosan shell around the oil droplets, which is responsible for the nanoemulsion physical stabilization and for the maintenance of chitosan bioactive properties, such as mucoadhesion. Cytotoxicity test was performed on four different cell lines (HEp-2, Caco-2, WKD and McCoy cells) showing biocompatibility of the system. The maintenance and in some cases even a clear improvement in the essential oil antimicrobial activity towards nine bacterial and ten fungal strains, all of clinical relevance was verified for Lemongrass nanoemulsion.
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Affiliation(s)
- Maria Cristina Bonferoni
- Department of Drug Sciences, University of Pavia, Vle Taramelli 12, 27100 Pavia, Italy; Center for Health Technology (CHT), University of Pavia, Via A. Ferrata 1, 27100 Pavia, Italy.
| | - Giuseppina Sandri
- Department of Drug Sciences, University of Pavia, Vle Taramelli 12, 27100 Pavia, Italy; Center for Health Technology (CHT), University of Pavia, Via A. Ferrata 1, 27100 Pavia, Italy
| | - Silvia Rossi
- Department of Drug Sciences, University of Pavia, Vle Taramelli 12, 27100 Pavia, Italy; Center for Health Technology (CHT), University of Pavia, Via A. Ferrata 1, 27100 Pavia, Italy
| | - Donatella Usai
- Department of Biomedical Sciences, University of Sassari, V.le San Pietro 43/C, 07100, Sassari, Italy
| | - Ioannis Liakos
- Smart Materials Group, Nanophysics Department, Italian Institute of Technology (IIT), Via Morego 30, 16163 Genoa, Italy
| | - Alice Garzoni
- Department of Drug Sciences, University of Pavia, Vle Taramelli 12, 27100 Pavia, Italy
| | - Maura Fiamma
- Department of Biomedical Sciences, University of Sassari, V.le San Pietro 43/C, 07100, Sassari, Italy
| | - Stefania Zanetti
- Department of Biomedical Sciences, University of Sassari, V.le San Pietro 43/C, 07100, Sassari, Italy
| | - Athanassia Athanassiou
- Smart Materials Group, Nanophysics Department, Italian Institute of Technology (IIT), Via Morego 30, 16163 Genoa, Italy
| | - Carla Caramella
- Department of Drug Sciences, University of Pavia, Vle Taramelli 12, 27100 Pavia, Italy; Center for Health Technology (CHT), University of Pavia, Via A. Ferrata 1, 27100 Pavia, Italy
| | - Franca Ferrari
- Department of Drug Sciences, University of Pavia, Vle Taramelli 12, 27100 Pavia, Italy; Center for Health Technology (CHT), University of Pavia, Via A. Ferrata 1, 27100 Pavia, Italy
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Fungal isolation from disinfectant solutions of contact lens storage cases among asymptomatic users. Eye Contact Lens 2014; 41:87-90. [PMID: 25503912 DOI: 10.1097/icl.0000000000000069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the incidence of fungal contamination of store disinfectant solutions contained in contact lens storage cases belonging to asymptomatic contact lens users. METHODS Asymptomatic contact lens users were asked to bring their storage cases, lenses included, without having opened the lid of the cup after placing lenses inside. The following information was recorded: age, sex, type of refractive error, contact lens material, schedule of wear, and brand of disinfectant solution. Included subjects had to comply with lens handling, cleaning, and replacement instructions given by the manufacturer or their attending optometrist. One sample per cup of contact lens case was collected using a sterile syringe. Samples were cultured on proper media for 96 hr at 35°C. Fungi were identified to species level by standard methodology. RESULTS A total of 216 samples were collected from 117 contact lens storage cases. All participants were using monthly disposable hydrogel lenses on a daily wear basis. Seven fungal species were isolated from 15 specimens (6.9%) collected from 12 storage cases (10.2%). These included one Fusarium solani, four Aspergillus niger, two Aspergillus fumigatus, five Candida parapsilosis, one Candida tropicalis, one Rhodotorula rubra, and one F. solani in combination with Candida guilliermondii. Disinfectant solutions containing hydrogen peroxide were found to be less effective than various alternative solutions in eliminating fungal species. CONCLUSIONS The results of this study show that even when contact lens users report compliance for handling, cleaning, and replacement according to the manufacturer's instructions, the potential risk of contact lens-related fungal keratitis still remains.
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