The Role of Biofilms in Contact Lens Associated Fungal Keratitis

Yi, Jipan; Sun, Yao; Zeng, Chenghong; Kostoulias, Xenia; Qu, Yue

doi:10.3390/antibiotics12101533

Antibiotics

2023

DOI: 10.3390/antibiotics12101533

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The Role of Biofilms in Contact Lens Associated Fungal Keratitis

Jipan Yi,

Yao Sun,

Chenghong Zeng

et al.

Abstract: Biofilm formation is an important microbial strategy for fungal pathogens, such as Fusarium, Aspergillus, and Candida, to establish keratitis in patients wearing soft contact lenses. Despite the well-documented 2006 outbreak of Fusarium keratitis that eventually led to the withdrawal of the Bausch & Lomb multipurpose lens care solution ReNu with MoistureLoc (“MoistureLoc”) from the global market, contact lens care systems and solutions currently available on the market do not specifically target fungal bio… Show more

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2024

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Cited by 3 publications

References 89 publications

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Macrophage Membrane-Coated Nanoparticles for the Delivery of Natamycin Exhibit Increased Antifungal and Anti-Inflammatory Activities in Fungal Keratitis

Liu,

Zhang,

Peng

et al. 2024

ACS Appl. Mater. Interfaces

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This study aims to explore the efficacy and safety of macrophage membrane-coated nanoparticles for the delivery of natamycin (NAT) in the therapy of fungal keratitis (FK). Macrophage membranes were isolated and identified by immunofluorescence staining (IFS). NAT was encapsulated into poly(lactic-co-glycolic acid) (PLGA). Fungal stimulated macrophage membranes (M1) or unstimulated membranes (M) were separately mixed and sonicated with PLGA nanoparticles. The biocompatible nanoparticles (PLGA-NAT, PLGA-NAT@M, and PLGA-NAT@M1) were characterized with zeta-sizer analysis, transmission electron microscopy (TEM), and Western blot. Drug encapsulation and loading efficiency and the release of NAT in the nanoparticles were detected by ultraviolet spectrophotometry. The cytotoxicity, ocular surface toxicity and irritability, and systemic safety of nanoparticles with different concentrations were assessed. In vitro, we examined the antifungal properties of the nanoparticles. The eye surface retention time, drug release, and curative effects on FK were evaluated in vitro and in vivo. IFS results showed the separation of the macrophage membrane and nucleus. The prepared nanoparticles had a typical "core−shell" structure and uniform nanometer size, and the membrane proteins were retained on the membrane allowing to exert functional effects of macrophage. The loading efficiencies of PLGA-NAT@M and PLGA-NAT@M1 were 7.6 and 6.7%, respectively. The encapsulation efficiencies of PLGA-NAT@M and PLGA-NAT@M1 were 51.2 and 41.5%, respectively. PLGA-NAT@M and PLGA-NAT@M1 could gradually release NAT and reduce the clearance of the ocular surface. Macrophage membranes enhanced the antifungal activity of PLGA-NAT. Furthermore, the membrane coated with macrophage increased the biocompatibility and decreased the corneal toxicity of nanoparticles. In vivo, PLGA-NAT@M1 significantly alleviated the severity of FK. In vitro, PLGA@M and PLGA@M1 reduced the protein levels of inflammatory cytokines after fungal stimulation. The prepared PLGA-NAT@M1 has good physical properties and biosafety. It could evade ocular surface clearance, release NAT gradually, and achieve high antifungal and anti-inflammatory efficiencies to FK. Macrophage membrane-coated nanoparticles clinically have high application potential to the treatment of FK.

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Macrophage Membrane-Coated Nanoparticles for the Delivery of Natamycin Exhibit Increased Antifungal and Anti-Inflammatory Activities in Fungal Keratitis

Liu,

Zhang,

Peng

et al. 2024

ACS Appl. Mater. Interfaces

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Hand-Washing Habits in a Sample of Spanish Soft Contact Lens Wearers

Alonso,

Navarro,

Cardona

2024

Healthcare

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Contact lens (CL) wear is a safe method for the correction of refractive errors. However, rare, severe ocular complications may occur which may lead to visual loss. As most of these complications are related to poor patient compliance with care and maintenance instructions, resulting in the contamination of hands, CLs and accessories, it was the purpose of this study to assess hand-washing habits in a sample of Spanish soft CL wearers. Hand hygiene was explored through a self-reported online survey and via an in-office practical demonstration in a subset of those users answering the survey. A total of 198 surveys were analyzed, and 18 CL users participated in the practical demonstration. Overall, hand-washing habits were not adequate, with 35 (17.8%) and 103 (52.2%) participants reporting not always washing their hands prior to CL or storage case manipulation, respectively. While 161 (81.3%) participants dried their hands after washing, 132 of these (82.1%) used non-disposable cloth towels. Participants receiving specific hand-washing information from their practitioners (141, or 71.1%) had better hand hygiene (p < 0.05). During the practical demonstration, 13 (72.2%) participants used water and soap to wash their hands, but only 3 (16.7%) displayed correct hand washing routines. Complete patient education, as well as practical reminders at all follow-up visits, are essential to ensure better hand hygiene in order to reduce the probability of ocular complications and to guarantee safe and satisfactory CL use.

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Long-Term Prevalence of Fungal Keratitis at a Swiss Tertiary Eye Clinic

Bajka,

Said,

Quiblier

et al. 2024

Microorganisms

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Fungal keratitis is a rare yet severe infection of the cornea. Fungal species distribution depends on the climate and socioeconomic status and can show regional variation. This retrospective single-center study was conducted at a tertiary eye care center and the collaborating Institute of Medical Microbiology in Switzerland. On investigating all fungal-positive corneal scrapings and contact lens assessments of patients with keratitis from January 2012 to December 2023, 206 patients were identified, of which 113 (54.9%) were female. The median age was 38 (IQR 29.8, [18–93]), and 154 (74.8%) applied contact lenses. The most commonly found pathogen was Candida spp., followed by Fusarium spp. Molds were 1.8 times more common than yeasts. Linear regression showed no significant increase or decrease in the infection rate over time (p = 0.5). In addition, 10 patients (4.9%) were found to have coinfections with Acanthamoeba, 11 (5.3%) with HSV-1, none with HSV-2, and 4 (1.9%) with VZV. This study provides a long-term overview of fungal-positive corneal scrapings and contact lens specimens of patients with fungal keratitis. Based on our results, coinfections with Acanthamoeba, HSV, and VZV are frequent, especially in patients wearing contact lenses. Thus, wearing contact lenses may facilitate coinfection in fungal keratitis.

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The Role of Biofilms in Contact Lens Associated Fungal Keratitis

Cited by 3 publications

References 89 publications

Macrophage Membrane-Coated Nanoparticles for the Delivery of Natamycin Exhibit Increased Antifungal and Anti-Inflammatory Activities in Fungal Keratitis

Macrophage Membrane-Coated Nanoparticles for the Delivery of Natamycin Exhibit Increased Antifungal and Anti-Inflammatory Activities in Fungal Keratitis

Hand-Washing Habits in a Sample of Spanish Soft Contact Lens Wearers

Long-Term Prevalence of Fungal Keratitis at a Swiss Tertiary Eye Clinic

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