Brown Allison C, Ross Jonathan, Jones Daniel B, Collier Sarah A, Ayers Tracy L, Hoekstra Robert M, Backensen Bryon, Roy Sharon L, Beach Michael J, Yoder Jonathan S
National Center for Emerging and Zoonotic Infectious Diseases (A.C.B., J.R., S.C., T.L.A., R.M.H., S.L.R., M.J.B., and J.S.Y.), Centers for Disease Control and Prevention, Atlanta, GA; Department of Ophthalmology (D.B.J.), Baylor College of Medicine, Houston, TX; and New York State Department of Health (B.B.), Albany, NY.
Eye Contact Lens. 2018 Sep;44 Suppl 1:S173-S178. doi: 10.1097/ICL.0000000000000365.
To identify modifiable risk factors contributing to Acanthamoeba keratitis (AK) infection.
A case-control investigation was conducted. Case patients were soft contact lens wearers with laboratory-confirmed AK. Control were soft contact lens wearers ≥12 years of age, with no history of AK. Case patients were recruited from 14 ophthalmology referral centers and a clinical laboratory. Control were matched on state of residence and type of primary eye care provider (ophthalmologist or optometrist). Participants were interviewed using a standardized questionnaire. Univariable and multivariable conditional logistic regression analyses were conducted. Matched odds ratios (mORs) were calculated.
Participants included 88 case patients and 151 matched control. Case patients were more likely to be aged <25 years (unadjusted mOR 2.7, 95% confidence interval 1.3-5.5) or aged >53 years (mOR 2.5, 1.1-5.7), and more likely to be men (mOR 2.6, 1.4-4.8). Unadjusted analyses identified multiple risk factors: rinsing (mOR 6.3, 1.3-29.9) and storing lenses in tap water (mOR 3.9, 1.2-12.3), topping off solution in the lens case (mOR 4.0, 2.0-8.0), having worn lenses ≤5 years (mOR 2.4, 1.3-4.4), rinsing the case with tap water before storing lenses (mOR 2.1, 1.1-4.1), and using hydrogen peroxide (mOR 3.6, 1.1-11.7) versus multipurpose solution. Significant risk factors in multivariable modeling included age >53 years, male sex, topping off, and using saline solution.
Numerous modifiable risk factors for AK were identified, mostly involving hygiene practices. To reduce the risk of AK, lens wearers should observe recommended lens care practices.
确定导致棘阿米巴角膜炎（AK）感染的可改变风险因素。
进行了一项病例对照研究。病例患者为软性隐形眼镜佩戴者且经实验室确诊患有AK。对照为年龄≥12岁、无AK病史的软性隐形眼镜佩戴者。病例患者从14个眼科转诊中心和一个临床实验室招募。对照在居住州和初级眼保健提供者类型（眼科医生或验光师）方面进行匹配。使用标准化问卷对参与者进行访谈。进行单变量和多变量条件逻辑回归分析。计算匹配比值比（mOR）。
参与者包括88例病例患者和151例匹配对照。病例患者更有可能年龄<25岁（未调整mOR 2.7，95%置信区间1.3 - 5.5）或年龄>53岁（mOR 2.5，1.1 - 5.7），且更有可能为男性（mOR 2.6，1.4 - 4.8）。未调整分析确定了多个风险因素：冲洗（mOR 6.3，1.3 - 29.9）和将镜片储存在自来水中（mOR 3.9，1.2 - 12.3）、在镜盒中补充护理液（mOR 4.0，2.0 - 8.0）、佩戴镜片≤5年（mOR 2.4，1.3 - 4.4）、在储存镜片前用自来水冲洗镜盒（mOR 2.1，1.1 - 4.1）以及使用过氧化氢护理液（mOR 3.6，1.1 - 11.7）而非多功能护理液。多变量建模中的显著风险因素包括年龄>53岁、男性、补充护理液以及使用生理盐水。
确定了众多AK的可改变风险因素，大多涉及卫生习惯。为降低AK风险，隐形眼镜佩戴者应遵循推荐的镜片护理方法。
