Ma Siu-keung Edmond, So Kellie, Chung Pui-hong, Tsang Ho-fai Thomas, Chuang Shuk-kwan
Surveillance and Epidemiology Branch, Centre for Health Protection, Department of Health, 147C Argyle Street, Kowloon, Hong Kong Special Administrative Region.
Int J Infect Dis. 2009 Jul;13(4):443-8. doi: 10.1016/j.ijid.2007.12.018. Epub 2008 Nov 18.
Starting in mid-2005, an increase in fungal keratitis caused by Fusarium spp was observed among contact lens wearers in Hong Kong, Singapore, and the USA. The objective of this study was to describe the outbreak and to determine any association with the use of Bausch & Lomb (B&L) ReNu contact lens solution.
We defined a case as a disposable contact lens user with ophthalmologist-diagnosed keratitis and a positive culture of Fusarium spp reported to the Department of Health from January 1, 2005 to May 31, 2006. We identified cases through inpatient discharge data and the electronic laboratory databases of all public hospitals, and from physician reporting. Controls were recruited from three outpatient clinics. Risk factors were collected using a standardized questionnaire and analyzed by univariate analysis and binary logistic regression.
From January 2005 through May 2006, we identified 33 cases of Fusarium keratitis. Most were in young adults (mean age 28 years) who presented with eye pain (100%), redness (84%), photophobia (41%), and tearing (34%). Twenty-four cases and 86 controls were recruited in the case-control study. By logistic regression, B&L ReNu solution showed the strongest association with being a case (adjusted odds ratio 26.1, 95% confidence interval 3.0-225.3) after adjusting for potential confounders.
Using B&L ReNu contact lens solution was strongly associated with Fusarium keratitis among disposable contact lens users in Hong Kong. B&L ReNu with MoistureLoc was permanently withdrawn from the market globally in May 2006.
自2005年年中起，在香港、新加坡和美国的隐形眼镜佩戴者中，观察到由镰刀菌属引起的真菌性角膜炎病例有所增加。本研究的目的是描述此次疫情暴发情况，并确定其与使用博士伦（B&L）润明隐形眼镜护理液之间的关联。
我们将病例定义为2005年1月1日至2006年5月31日期间，使用一次性隐形眼镜且经眼科医生诊断为角膜炎，同时向卫生部门报告镰刀菌属培养结果呈阳性的患者。我们通过住院患者出院数据、所有公立医院的电子实验室数据库以及医生报告来确定病例。对照组从三家门诊诊所招募。使用标准化问卷收集危险因素，并通过单因素分析和二元逻辑回归进行分析。
从2005年1月至2006年5月，我们共确定了33例镰刀菌性角膜炎病例。大多数患者为年轻人（平均年龄28岁），症状包括眼痛（100%）、眼红（84%）、畏光（41%）和流泪（34%）。在病例对照研究中，共招募了24例病例和86名对照。经逻辑回归分析，在对潜在混杂因素进行调整后，博士伦润明护理液与病例组的关联最为显著（调整后的优势比为26.1，95%置信区间为3.0 - 225.3）。
在香港，使用博士伦润明隐形眼镜护理液与一次性隐形眼镜使用者发生镰刀菌性角膜炎密切相关。含MoistureLoc的博士伦润明护理液于2006年5月在全球范围内永久退市。
