National outbreak of Acanthamoeba keratitis associated with use of a contact lens solution, United States.
An outbreak of Acanthamoeba keratitis, a rare, potentially blinding, corneal infection, was detected in the United States in 2007; cases had been increasing since 2004. A case-control study was conducted to investigate the outbreak. We interviewed 105 case-patients from 30 states and 184 controls matched geographically and by contact lens use. Available contact lenses, cases, solutions, and corneal specimens from case-patients were cultured and tested by molecular methods. In multivariate analyses, case-patients had significantly greater odds of having used Advanced Medical Optics Complete Moisture Plus (AMOCMP) solution (odds ratio 16.9, 95% confidence interval 4.8-59.5). AMOCMP manufacturing lot information was available for 22 case-patients, but none of the lots were identical. Three unopened bottles of AMOCMP tested negative for Acanthamoeba spp. Our findings suggest that the solution was not intrinsically contaminated and that its anti-Acanthamoeba efficacy was likely insufficient. Premarket standardized testing of contact lens solutions for activity against Acanthamoeba spp. is warranted.
Verani
Jennifer R
JR
Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. jverani@cdc.gov
Lorick
Suchita A
SA
Yoder
Jonathan S
JS
Beach
Michael J
MJ
Braden
Christopher R
CR
Roberts
Jacquelin M
JM
Conover
Craig S
CS
Chen
Sue
S
McConnell
Kateesha A
KA
Chang
Douglas C
DC
Park
Benjamin J
BJ
Jones
Dan B
DB
Visvesvara
Govinda S
GS
Roy
Sharon L
SL
D000048:Acanthamoeba / Q000302:isolation & purification; D015823:Acanthamoeba Keratitis / Q000453:epidemiology* / Q000469:parasitology / Q000635:transmission; D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D016022:Case-Control Studies; D002648:Child; D021821:Communicable Diseases, Emerging / Q000453:epidemiology* / Q000469:parasitology / Q000635:transmission; D018639:Contact Lens Solutions / Q000009:adverse effects* / Q000032:analysis; D004196:Disease Outbreaks; D004340:Drug Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D018639:Contact Lens Solutions