Alasadi Salah Zuhair, Ibraheim Wijdan, Almusawi Loay Abdulmutalib
Department of Surgery, College of Medicine, University of Basrah, Basrah, Iraq.
Department of Microbiology, College of Medicine, University of Basrah, Basrah, Iraq.
Clin Ophthalmol. 2022 Nov 4;16:3651-3660. doi: 10.2147/OPTH.S383086. eCollection 2022.
Contamination of CLs and accessories risks potentially devastating microbial keratitis. We aimed to explore the rate of microbial contamination and predisposing factors among a group of asymptomatic young medical students.
The study included 115 healthy female medical students with a mean age of 21.64 ± 2.02 years between January and November 2021. Information about CL use, wear and care was gathered. Each participant's CL and case were swabbed for microbiological identification. Univariable and multivariable analyses were conducted to look for associations with a range of factors.
Overall, 91 participants (79.13%) had at least one contaminated sample (lens and/or case). The rates of contamination of CL and their cases were 66% and 76.5%, respectively. Higher contamination rates were caused by gram-negative bacteria (60% of the contaminated samples) with P. aeruginosa being the most common contaminant both for CL and cases, whereas S. epidermidis and S. aureus were the most common contaminants for the CL and cases, respectively, regarding gram-positive contamination. Multivariable analysis showed younger age as a significant predictor of pseudomonas contamination of the lenses and cases (OR: 12.302, 6.555 for CL & cases, respectively; P = 0.001 for both). Older age was a significant predictor of K. pneumoniae contamination (OR: 4.154, P = 0.007). Pseudomonas contamination of both lenses and cases was predicted by the type of solution used (OR: 10.8 and 13.5, P = 0.001 and 0.003 for bottled and distilled water vs commercially available solutions for CL; OR: 4.5 and 5.8, P = 0.045 and 0.004, respectively, for cases). Pseudomonas case contamination was associated with low frequency of solution change.
Microbial contamination rate of soft CL and their cases is high among young medical students in comparison to previously reported rates and was predisposed by several poor hygienic practices and wearing regimens.
角膜接触镜（CL）及其配件的污染有引发潜在毁灭性微生物性角膜炎的风险。我们旨在探究一组无症状年轻医学生中的微生物污染率及易感因素。
该研究纳入了2021年1月至11月期间115名平均年龄为21.64±2.02岁的健康女医学生。收集了有关CL使用、佩戴和护理的信息。对每位参与者的CL及其镜盒进行拭子采样以进行微生物鉴定。进行单变量和多变量分析以寻找与一系列因素的关联。
总体而言，91名参与者（79.13%）至少有一个样本（镜片和/或镜盒）被污染。CL及其镜盒的污染率分别为66%和76.5%。革兰氏阴性菌导致的污染率较高（占污染样本的60%），铜绿假单胞菌是CL和镜盒中最常见的污染物，而表皮葡萄球菌和金黄色葡萄球菌分别是CL和镜盒革兰氏阳性菌污染中最常见的污染物。多变量分析显示，年龄较小是镜片和镜盒假单胞菌污染的显著预测因素（CL和镜盒的比值比分别为：12.302、6.555；两者P值均为0.001）。年龄较大是肺炎克雷伯菌污染的显著预测因素（比值比：4.154，P = 0.007）。镜片和镜盒的假单胞菌污染可通过所使用的溶液类型预测（瓶装水和蒸馏水与CL的市售溶液相比，镜片的比值比为：10.8和13.5，P值分别为0.001和0.003；镜盒的比值比分别为：4.5和5.8，P值分别为0.045和0.004）。镜盒假单胞菌污染与溶液更换频率低有关。
与先前报道的比率相比，年轻医学生中软性CL及其镜盒的微生物污染率较高，且由一些不良卫生习惯和佩戴方案所致。
