Contact lens care system의 미생물 오염

Microbial contamination in contact lens care systems

Soft contact lens 착용자 40명의 lens 관리체계와 결막의 미생물 오염을 조사하였다. Contact lens 착용자의 연령은 19-27세(평균22세)로 대부분 hydrogel contact lens를 1년 이하 착용하고 있었고 lens case의 사용기간은 1주-3개월 43%, 4-6개월 52%였다. lens의 소독은 27명(67%)이 화학소독을 실시하고 있었고, hydrogen peroxide와 열소독은 각각 8명(20%), 5명 이었다. Rinsing solution의 경우 14명이 시판되는 nonpreserved saline을, 26명(65%)은 preserved saline을 사용하고 있었다. Lens case 및 결막의 세균오염률은 각각 62%, 17%로 lens case의 세균오염률이 가장 높고 unpreserved saline(8/14), chemical(5/27), 그리고 결막순이었다. 진균 오염율은 lens case 및 결막에서 각각 67%, 15%이였고, 주로 lens case, unpreserved saline, 결막에서 오염이 심했다. Hydrogen peroxide 소독은 화학소독의 경우보다 hydrogen peroxide 용액 자체는 오염률이 현저하게 낮았으나 hydrogen peroxide 소독에 의한 contact lens 관리체계는 오염률에 있어서 다른 소독방법을 사용하는 관리체계와 유의성 있는 차이가 없었다. Pseudomonas aeruginosa는 각각 5개의 lens case(l3%)와 2개의 결막(5%)에서 또 Candida albicans는 11개의 lens case(27%)와 5개의 결막(12%)에서 각각 분리되었으며, 오염원 lens case와 결막으로부터 각각 Pseudomonas aeruginosa, Escherichia coli, Candida dlbicans, Aspergillus fumigatus와 Pseudomonas aeruginosa, Candida albicans, Aspergillus fumigatus가 분리 확인되었다. 조사대상중 Acanthamoeba의 오염은 확인되지 않았다.

The microbial contamination in contact lens care systems and conjunctivas of 40 asymptomatic cosmetic soft contact lens wearers was investigated. Patient ages ranged from 19 to 27(mean:22), most of them have used hydrogel contact lenses for less than 1 year, and the ages of lens cases were 1 weeks ~ 3 months (43 %) or 4~6 months (52%). Twenty-seven patients (67%) chemically disinfected their lenses and 8(20 %) used hydrogen peroxide, and 5 used heat to disinfect. Fourteen patients used commercial non-preserved saline, and 26(65%) were using commercial preserved saline. Sixty-two percent of the patients had bacterial contamination of lens case, and 17% had conjunctival contamination. The bacterial contamination rate was highest in lens cases, followed by unpreserved salines, disinfecting chemicals(non-hydrogen peroxide), and conjunctivas. The fungal contamination rate of cases and conjunctivas was 67% and 15%, respectively, and lens case, unpreserved saline, and conjunctiva seemed more susceptible to contamination. The use of hydrogen peroxide for disinfection rather than chemical disinfection was associated remarkabley with decreased contamination of solution itself, and there was no significant difference in contamination rates between hydrogen peroxide care system and other disinfecting systems. Five of lens cases(13%) and 2 conjunctivas(5%) were contaminated with Pseudomonas aeruginosa, and Candida albicans were isolated from 11cases (27%) and 5 conjunctivas (12%). Of the organisms that were contaminated lens cases and conjunctivas, Pseudomonas aeruginosa, Escherichia coli, Candida albicans, and Aspergillus fumigatus were isolated from lens cases, whereas Pseudomonas aeruginosa, Candida albicans, and Aspergillus fumigatus were recorvered from conjunctivas. Fortunately all of the these tested samples showed 0% of Acanthamoeba in this investigation.