title: Colonization of hydrogel lenses with Streptococcus pneumoniae: risk of development of corneal infiltrates.
abstract: OBJECTIVE
  To report the association between colonization of contact lenses with Streptococcus pneumoniae and the observation of corneal infiltrative events in a group of patients wearing disposable hydrogel lenses on an extended-wear schedule.
  
  
  METHODS
  In a prospective clinical trial, 330 patients wore disposable hydrogels on a 6-night extended-wear and replacement schedule. The contact lens, lid, and conjunctival microbiota of these subjects was analyzed at frequent intervals and at the time of an adverse event.
  
  
  RESULTS
  Streptococcus pneumoniae was an uncommon isolate and was recovered from only one of the 3,763 conjunctival samples, five (0.1%) of the 3,764 lid samples, and 33 (0.8%) of the 4,315 contact lens samples. Of the 33 lens samples, 10 (30%) were associated with corneal infiltrative events. Many of the events were mild inflammatory responses and resolved rapidly on discontinuation of lens wear. The presence of S. pneumoniae on the contact lens was associated with a significant risk of development of corneal infiltrates (odds ratio, 3.0; p = 0.0227, logistic-regression analysis).
  
  
  CONCLUSIONS
  Presence of S. pneumoniae on hydrogel lenses is a significant risk factor for the development of corneal infiltrates.
authors.affiliation: Cornea and Contact Lens Research Unit, School of Optometry, University of New South Wales and the Cooperative Research Centre for Eye Research and Technology, Sydney, Australia. P.Sankaridurg@cclru.randwick.unsw.edu.au
authors.forename: P R
authors.initials: PR
authors.lastname: Sankaridurg
authors.forename: S
authors.initials: S
authors.lastname: Sharma
authors.forename: M
authors.initials: M
authors.lastname: Willcox
authors.forename: D F
authors.initials: DF
authors.lastname: Sweeney
authors.forename: T J
authors.initials: TJ
authors.lastname: Naduvilath
authors.forename: B A
authors.initials: BA
authors.lastname: Holden
authors.forename: G N
authors.initials: GN
authors.lastname: Rao
mesh_terms: D000293:Adolescent; D000328:Adult; D015169:Colony Count, Microbial; D003228:Conjunctiva / Q000382:microbiology*; D003262:Contact Lenses, Extended-Wear / Q000382:microbiology*; D003316:Corneal Diseases / Q000382:microbiology*; D004209:Disposable Equipment; D015818:Eye Infections, Bacterial / Q000209:etiology; D005143:Eyelids / Q000382:microbiology*; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D011008:Pneumococcal Infections / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D013296:Streptococcus pneumoniae / Q000254:growth & development* / Q000302:isolation & purification
chemical_list: D020136:Hydrogel, Polyethylene Glycol Dimethacrylate