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Aeromonas caviae keratitis associated with contact lens wear. 2004

Antonio Pinna, and Leonardo A Sechi, and Stefania Zanetti, and Donatella Usai, and Francesco Carta
Institute of Ophthalmology, University of Sassari, Sassari, Italy. apinna@uniss.it

OBJECTIVE We report the first case of bilateral contact lens-related Aeromonas caviae keratitis associated with A. caviae contamination of the contact lens case. The presence of virulence factors produced by Aeromonas species was also investigated. METHODS Case report. METHODS Conjunctival swabs and corneal scrapings from both eyes were inoculated for culture. The contact lens case was also cultured. The isolate was analyzed for the presence of virulence properties, such as gelatinase and protease production. The presence of virulence genes, such as the cytolytic enterotoxin (AHCYTOEN) and type IV Aeromonas pilus (tap) genes, was investigated using polymerase chain reaction. The susceptibility of A. caviae to 6 commercial contact lens disinfecting solutions was tested. METHODS Culture results, protease activity, and gelatinase production were analyzed. Polymerase chain reaction amplification products were visualized in ethidium bromide-stained agarose gel. Bacterial growth after exposure to contact lens disinfecting solutions was assessed. RESULTS Aeromonas caviae was grown bilaterally from the conjunctiva, cornea, and contact lens case. The organism showed protease and gelatinase production. Polymerase chain reaction amplification revealed that the A. caviae strain contained the AHCYTOEN and tap virulence genes. Incubation for the minimum recommended time with all tested disinfecting solutions was effective in killing A. caviae. CONCLUSIONS Aeromonas caviae should be considered a possible etiologic agent of contact lens-associated keratitis. The presence of virulence factors may be important in determining corneal infection. Commercial contact lens disinfecting solutions, along with proper lens case hygiene, may be effective in preventing A. caviae keratitis in soft contact lens wearers.

UI MeSH Term Description Entries
D007634 Keratitis Inflammation of the cornea. Keratitides
D008297 Male Males
D008826 Microbial Sensitivity Tests Any tests that demonstrate the relative efficacy of different chemotherapeutic agents against specific microorganisms (i.e., bacteria, fungi, viruses). Bacterial Sensitivity Tests,Drug Sensitivity Assay, Microbial,Minimum Inhibitory Concentration,Antibacterial Susceptibility Breakpoint Determination,Antibiogram,Antimicrobial Susceptibility Breakpoint Determination,Bacterial Sensitivity Test,Breakpoint Determination, Antibacterial Susceptibility,Breakpoint Determination, Antimicrobial Susceptibility,Fungal Drug Sensitivity Tests,Fungus Drug Sensitivity Tests,Sensitivity Test, Bacterial,Sensitivity Tests, Bacterial,Test, Bacterial Sensitivity,Tests, Bacterial Sensitivity,Viral Drug Sensitivity Tests,Virus Drug Sensitivity Tests,Antibiograms,Concentration, Minimum Inhibitory,Concentrations, Minimum Inhibitory,Inhibitory Concentration, Minimum,Inhibitory Concentrations, Minimum,Microbial Sensitivity Test,Minimum Inhibitory Concentrations,Sensitivity Test, Microbial,Sensitivity Tests, Microbial,Test, Microbial Sensitivity,Tests, Microbial Sensitivity
D010861 Fimbriae, Bacterial Thin, hairlike appendages, 1 to 20 microns in length and often occurring in large numbers, present on the cells of gram-negative bacteria, particularly Enterobacteriaceae and Neisseria. Unlike flagella, they do not possess motility, but being protein (pilin) in nature, they possess antigenic and hemagglutinating properties. They are of medical importance because some fimbriae mediate the attachment of bacteria to cells via adhesins (ADHESINS, BACTERIAL). Bacterial fimbriae refer to common pili, to be distinguished from the preferred use of "pili", which is confined to sex pili (PILI, SEX). Bacterial Fimbriae,Bacterial Pili,Common Fimbriae,Common Pili,Pili, Bacterial,Pili, Common,Bacterial Fimbria,Bacterial Pilus,Common Fimbria,Common Pilus,Fimbria, Bacterial,Pilus, Bacterial,Fimbria, Common,Fimbriae, Common,Pilus, Common
D003228 Conjunctiva The mucous membrane that covers the posterior surface of the eyelids and the anterior pericorneal surface of the eyeball. Bulbar Conjunctiva,Palpebral Conjunctiva,Plica Semilunaris of Conjunctiva,Plicae Semilunares of Conjunctiva,Tunica Conjunctiva,Conjunctiva, Bulbar,Conjunctiva, Palpebral,Conjunctivas
D003263 Contact Lenses, Hydrophilic Soft, supple contact lenses made of plastic polymers which interact readily with water molecules. Many types are available, including continuous and extended-wear versions, which are gas-permeable and easily sterilized. Lenses, Contact, Hydrophilic,Soft Contact Lenses,Hydrophilic Contact Lens,Soft Contact Lens,Contact Lens, Hydrophilic,Contact Lens, Soft,Contact Lenses, Soft,Hydrophilic Contact Lenses,Lens, Hydrophilic Contact,Lens, Soft Contact,Lenses, Hydrophilic Contact,Lenses, Soft Contact
D003315 Cornea The transparent anterior portion of the fibrous coat of the eye consisting of five layers: stratified squamous CORNEAL EPITHELIUM; BOWMAN MEMBRANE; CORNEAL STROMA; DESCEMET MEMBRANE; and mesenchymal CORNEAL ENDOTHELIUM. It serves as the first refracting medium of the eye. It is structurally continuous with the SCLERA, avascular, receiving its nourishment by permeation through spaces between the lamellae, and is innervated by the ophthalmic division of the TRIGEMINAL NERVE via the ciliary nerves and those of the surrounding conjunctiva which together form plexuses. (Cline et al., Dictionary of Visual Science, 4th ed) Corneas
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D004768 Enterotoxins Substances that are toxic to the intestinal tract causing vomiting, diarrhea, etc.; most common enterotoxins are produced by bacteria. Staphylococcal Enterotoxin,Enterotoxin,Staphylococcal Enterotoxins,Enterotoxin, Staphylococcal,Enterotoxins, Staphylococcal
D004866 Equipment Contamination The presence of an infectious agent on instruments, prostheses, or other inanimate articles. Contamination, Equipment,Contaminations, Equipment,Equipment Contaminations

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