title: Potential sources of bacteria that are isolated from contact lenses during wear.
abstract: OBJECTIVE
  The aim of this paper was to determine the possible contamination sources of contact lenses during wear.
  
  
  METHODS
  Potential sources of the microbiota that colonized hydrogel contact lenses during wear were examined. The microorganisms that colonize contact lenses were grown, identified, and compared to those microorganisms that colonized the lower lid margins, upper bulbar conjunctiva, hands, and contact lens cases of contact lens wearers. In addition, the incidence of contamination of the domestic water supply in the Sydney area was obtained, and this was compared to the incidence of colonization of contact lenses by microorganisms in general and gram-negative bacteria in particular.
  
  
  RESULTS
  There was a wide diversity of bacteria that were isolated from each site sampled. Coagulase-negative staphylococci and Propionibacterium spp. were the most common isolates from all ocular sites examined, and constituted the normal ocular microbiota. Other bacteria, including members of the families Enterobacteriaceae and Pseudomonadaceae, were isolated infrequently from all sites, but most frequently from contact lens cases. Statistical analysis revealed that there was a correlation between the isolation of bacteria from the contact lens and the lower lid margin (p < 0.001). Analysis of this correlation revealed that this was true for the normal microbiota. A correlation was also noted between the colonization of contact lenses by gram-negative bacteria and contamination of the domestic water supply.
  
  
  CONCLUSIONS
  This study has demonstrated that the likely route for the normal ocular microbiota colonizing contact lenses is via the lid margins, whereas colonization by gram-negative bacteria, including potential agents of microbial keratitis, is likely to be from the domestic water supply.
authors.affiliation: School of Optometry and Cooperative Research Centre for Eye Research and Technology, University of New South Wales, Sydney, Australia. M.Willcox@cclru.unsw.edu.au
authors.forename: M D
authors.initials: MD
authors.lastname: Willcox
authors.forename: K N
authors.initials: KN
authors.lastname: Power
authors.forename: F
authors.initials: F
authors.lastname: Stapleton
authors.forename: C
authors.initials: C
authors.lastname: Leitch
authors.forename: N
authors.initials: N
authors.lastname: Harmis
authors.forename: D F
authors.initials: DF
authors.lastname: Sweeney
mesh_terms: D001419:Bacteria / Q000254:growth & development / Q000302:isolation & purification*; D015169:Colony Count, Microbial; D003262:Contact Lenses, Extended-Wear / Q000382:microbiology*; D003263:Contact Lenses, Hydrophilic / Q000382:microbiology*; D004866:Equipment Contamination; D005123:Eye / Q000382:microbiology*; D005385:Fingers / Q000382:microbiology; D006801:Humans; D017755:Prosthesis Fitting; D014871:Water Microbiology