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Bacillus cereus keratitis associated with contact lens wear.
Ophthalmology. 2001 Oct; 108(10):1830-4.O

Abstract

OBJECTIVE

We report the first case of contact lens-related Bacillus cereus keratitis and ulcer associated with B. cereus contamination of the contact lens case. This is also the first study to investigate and establish the genetic identity of an organism isolated from the cornea and contact lens case in a patient with contact lens-associated keratitis.

DESIGN

Case report.

INTERVENTION AND TESTING

Conjunctival swabs and corneal scrapings from the left eye were inoculated for culture. The contact lens case was also cultured. Antibiotic susceptibility testing was determined by agar disk diffusion method. Initial treatment with topical ciprofloxacin and fortified tobramycin was given. Genetic analysis of the bacterial isolates was performed using polymerase chain reaction (PCR) with enterobacterial repetitive intergenic consensus primers (ERIC; ERIC-PCR). Susceptibility of B. cereus to heat and contact lens disinfecting solutions containing hydrogen peroxide, hydrogen peroxide-catalase, polyquaternium-1, and polyaminopropyl biguanide (PAPB) was tested.

MAIN OUTCOME MEASURES

Clinical features, culture results, and antibiotic susceptibility testing were analyzed. The ERIC-PCR amplification products were visualized in ethidium bromide-stained agarose gel. Bacterial growth after exposure to heat and contact lens disinfecting solutions was assessed on blood agar plates.

RESULTS

B. cereus was grown from the conjunctiva, corneal ulcer, and contact lens case. All isolates were sensitive to gentamicin, tobramycin, ciprofloxacin, clindamycin, and vancomycin. The corneal ulcer gradually healed over the next 6 days. Results of ERIC-PCR showed that the isolates from the cornea and contact lens case were indistinguishable, thus demonstrating the source of infecting organism to be the contaminated contact lens case. Exposure to a temperature of 80 degrees C for 20 minutes and incubation with hydrogen peroxide-catalase, polyquaternium-1, and PAPB for the minimum recommended time failed to kill B. cereus. Only exposure to hydrogen peroxide for 4 hours eradicated the organism.

CONCLUSIONS

B. cereus should be considered a possible etiologic agent of contact lens-associated keratitis. Heat and many types of contact lens disinfecting solutions may be ineffective in eradicating B. cereus from contaminated contact lens cases. Only prolonged exposure to hydrogen peroxide appeared to be sporicidal to B. cereus in this study.

Authors+Show Affiliations

Institute of Ophthalmology, University of Sassari, Sassari, Italy. apinna@uniss.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

11581057

Citation

Pinna, A, et al. "Bacillus Cereus Keratitis Associated With Contact Lens Wear." Ophthalmology, vol. 108, no. 10, 2001, pp. 1830-4.
Pinna A, Sechi LA, Zanetti S, et al. Bacillus cereus keratitis associated with contact lens wear. Ophthalmology. 2001;108(10):1830-4.
Pinna, A., Sechi, L. A., Zanetti, S., Usai, D., Delogu, G., Cappuccinelli, P., & Carta, F. (2001). Bacillus cereus keratitis associated with contact lens wear. Ophthalmology, 108(10), 1830-4.
Pinna A, et al. Bacillus Cereus Keratitis Associated With Contact Lens Wear. Ophthalmology. 2001;108(10):1830-4. PubMed PMID: 11581057.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bacillus cereus keratitis associated with contact lens wear. AU - Pinna,A, AU - Sechi,L A, AU - Zanetti,S, AU - Usai,D, AU - Delogu,G, AU - Cappuccinelli,P, AU - Carta,F, PY - 2001/10/3/pubmed PY - 2001/10/19/medline PY - 2001/10/3/entrez SP - 1830 EP - 4 JF - Ophthalmology JO - Ophthalmology VL - 108 IS - 10 N2 - OBJECTIVE: We report the first case of contact lens-related Bacillus cereus keratitis and ulcer associated with B. cereus contamination of the contact lens case. This is also the first study to investigate and establish the genetic identity of an organism isolated from the cornea and contact lens case in a patient with contact lens-associated keratitis. DESIGN: Case report. INTERVENTION AND TESTING: Conjunctival swabs and corneal scrapings from the left eye were inoculated for culture. The contact lens case was also cultured. Antibiotic susceptibility testing was determined by agar disk diffusion method. Initial treatment with topical ciprofloxacin and fortified tobramycin was given. Genetic analysis of the bacterial isolates was performed using polymerase chain reaction (PCR) with enterobacterial repetitive intergenic consensus primers (ERIC; ERIC-PCR). Susceptibility of B. cereus to heat and contact lens disinfecting solutions containing hydrogen peroxide, hydrogen peroxide-catalase, polyquaternium-1, and polyaminopropyl biguanide (PAPB) was tested. MAIN OUTCOME MEASURES: Clinical features, culture results, and antibiotic susceptibility testing were analyzed. The ERIC-PCR amplification products were visualized in ethidium bromide-stained agarose gel. Bacterial growth after exposure to heat and contact lens disinfecting solutions was assessed on blood agar plates. RESULTS: B. cereus was grown from the conjunctiva, corneal ulcer, and contact lens case. All isolates were sensitive to gentamicin, tobramycin, ciprofloxacin, clindamycin, and vancomycin. The corneal ulcer gradually healed over the next 6 days. Results of ERIC-PCR showed that the isolates from the cornea and contact lens case were indistinguishable, thus demonstrating the source of infecting organism to be the contaminated contact lens case. Exposure to a temperature of 80 degrees C for 20 minutes and incubation with hydrogen peroxide-catalase, polyquaternium-1, and PAPB for the minimum recommended time failed to kill B. cereus. Only exposure to hydrogen peroxide for 4 hours eradicated the organism. CONCLUSIONS: B. cereus should be considered a possible etiologic agent of contact lens-associated keratitis. Heat and many types of contact lens disinfecting solutions may be ineffective in eradicating B. cereus from contaminated contact lens cases. Only prolonged exposure to hydrogen peroxide appeared to be sporicidal to B. cereus in this study. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/11581057/Bacillus_cereus_keratitis_associated_with_contact_lens_wear_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(01)00723-0 DB - PRIME DP - Unbound Medicine ER -