Alcon Research, LLC, Fort Worth, Texas, USA.
Microbiol Spectr. 2022 Feb 23;10(1):e0213821. doi: 10.1128/spectrum.02138-21. Epub 2022 Feb 9.
Microbial keratitis is a devastating disease that can cause eye damage and blindness and can be the result of infections by several common ocular pathogens. Importantly, some of these pathogens, such as , are particularly unsusceptible to biocides in common contact lens care solutions. Therefore, the disinfection efficacy of preservative-free (PF) disinfection systems against bacteria, fungi, and trophozoites and cysts should be assessed as products with the most potential to be efficacious against resistant organisms. PF disinfection systems were analyzed for antimicrobial efficacy. These were the one-step (hydrogen peroxide-based) Clear Care and Clear Care Plus systems and the two-step (povidone-iodine-based) Cleadew system. Stand-alone challenges using bacteria, fungi, and were prepared according to the International Standards Organization method 14729. These same challenges were also conducted in the presence of the following contact lenses: Boston RGP, Acuvue Oasys, Biofinity, Ultra, and 2-week PremiO. All challenges were performed at the manufacturer's recommended disinfection time. All preservative-free disinfection systems demonstrated similarly high rates of antimicrobial efficacy when challenged with bacteria or fungi, with or without lenses. However, both Clear Care and Clear Care Plus demonstrated significantly greater disinfection efficacy against trophozoites and cysts, with and without lenses ( < 0.05). Cleadew efficacy was impacted by the addition of contact lenses, whereas Clear Care/Clear Care Plus maintained similar efficacies in the absence or presence of lenses. While both hydrogen peroxide and povidone-iodine are highly effective against bacteria and fungi, hydrogen peroxide maintains significantly greater disinfection capabilities than povidone-iodine against all forms of . Understanding the most efficacious products will allow clinicians to best communicate to patients and consumers the safest products on the market to reduce adverse events, including microbial keratitis, during contact lens use.
微生物角膜炎是一种破坏性疾病，可导致眼部损伤和失明，可由几种常见的眼部病原体感染引起。重要的是，其中一些病原体，如 ，对常见隐形眼镜护理液中的消毒剂特别不敏感。因此，应评估不含防腐剂 (PF) 的消毒系统对细菌、真菌、滋养体和包囊的消毒效果，因为这些产品最有可能对耐药生物有效。分析了 PF 消毒系统的抗菌功效。这些是一步（基于过氧化氢）的 Clear Care 和 Clear Care Plus 系统以及两步（聚维酮碘）的 Cleadew 系统。根据国际标准化组织方法 14729 制备了单独的针对细菌、真菌和 的挑战。在以下隐形眼镜存在的情况下也进行了相同的挑战：Boston RGP、Acuvue Oasys、Biofinity、Ultra 和 2 周 PremiO。所有挑战均在制造商推荐的消毒时间进行。当单独挑战细菌或真菌时，所有不含防腐剂的消毒系统均表现出相似的高抗菌功效，无论是否存在镜片。然而，Clear Care 和 Clear Care Plus 对滋养体和包囊的消毒效果明显更好，无论是否有镜片（<0.05）。Cleadew 的功效受到隐形眼镜添加的影响，而 Clear Care/Clear Care Plus 在没有或存在隐形眼镜的情况下保持相似的功效。虽然过氧化氢和聚维酮碘对细菌和真菌都非常有效，但过氧化氢对所有形式的 保持比聚维酮碘更大的消毒能力。了解最有效的产品将使临床医生能够更好地向患者和消费者传达市场上最安全的产品，以减少在使用隐形眼镜期间发生包括微生物角膜炎在内的不良事件。
