Stehr-Green J K, Bailey T M, Brandt F H, Carr J H, Bond W W, Visvesvara G S
JAMA. 1987 Jul 3;258(1):57-60.
Acanthamoeba keratitis is a rare, serious protozoal infection of the cornea associated with wearing contact lenses. To identify risk factors in soft contact lens wearers, we interviewed 27 patients with Acanthamoeba keratitis and 81 uninfected matched controls to compare contact lens care practices, brands of contact lenses and associated solutions, and behavioral activities. Patients were significantly more likely than controls to use homemade saline instead of commercially prepared saline (21/27 [78%] vs 14/81 [17%]; odds ratio [OR], infinity), and wear their lenses while swimming (17/27 [63%] vs 24/81 [30%]; OR, 6.2). Contact lens disinfection schedules could be determined for 25 of the patients and all of the controls. Patients were significantly more likely than controls to disinfect their lenses less frequently than recommended by lens manufacturers (18/25 [72%] vs 26/81 [32%]; OR, 5.8). Microbiologic assay of contact lens solutions from controls showed frequent contamination with high levels of bacteria. Acanthamoeba species were isolated from homemade saline solutions from two controls. These findings emphasize adherence to recommended methods of soft contact lens care, especially when using nonsterile lens care solutions.
棘阿米巴角膜炎是一种罕见的、严重的与佩戴隐形眼镜相关的角膜原虫感染。为了确定软性隐形眼镜佩戴者的风险因素，我们采访了27例棘阿米巴角膜炎患者和81名未感染的匹配对照者，以比较隐形眼镜护理方法、隐形眼镜品牌及相关护理液，以及行为活动。与对照组相比，患者显著更有可能使用自制盐水而非市售盐水（21/27 [78%] 对14/81 [17%]；优势比 [OR]，无穷大），以及在游泳时佩戴隐形眼镜（17/27 [63%] 对24/81 [30%]；OR，6.2）。可以确定25例患者和所有对照者的隐形眼镜消毒时间表。与对照组相比，患者显著更有可能比镜片制造商建议的频率更低地对镜片进行消毒（18/25 [72%] 对26/81 [32%]；OR，5.8）。对对照组隐形眼镜护理液的微生物检测显示频繁受到高水平细菌污染。从两名对照者的自制盐溶液中分离出棘阿米巴属。这些发现强调要坚持软性隐形眼镜的推荐护理方法，尤其是在使用非无菌镜片护理液时。
