title: Do multipurpose contact lens disinfecting solutions work effectively against non-FDA/ISO recommended strains of bacteria and fungi?
abstract: OBJECTIVE
  Recent outbreaks of microbial keratitis have increased concerns about the efficacy of multipurpose solutions (MPS) against 'real-world' organisms. This study determined, in accordance with FDA/ISO standard methods, the effects of five MPS against clinical isolates and type strains of bacteria, and isolates of fungi from subjects' ocular structures; and of three MPS against environmental fungal isolates.
  
  
  METHODS
  MPS were challenged with bacteria (type strains (ATCC) and clinical isolates of bacterial pathogens obtained from a district hospital laboratory) and with fungal isolates from both the periocular and conjunctival structures and from environmental air.
  
  
  RESULTS
  All MPS demonstrated at least a 3-log reduction of challenged cell viability of all bacterial species tested, with the exception of MPS D against a canine infection Staphylococcus aureus isolate. Whilst all MPS tested were able to effect a 1.0-log reduction of viability of Fusarium solani (ATCC 36031), only two MPS had 90% viability reduction against all fungi of human origin and only one of these against all environmental fungal isolates. Effectiveness of these two solutions against fungal isolates compared to the remaining three MPS was found to be statistically significant (p = 0.003).
  
  
  CONCLUSIONS
  All MPS demonstrated a 99.9% viability reduction against a wide range of bacteria including major ocular pathogens not currently included in the FDA panel. The inability of three MPS to achieve a 90% reduction against fungal isolates is of concern as there has been a recent upsurge in reports of fungal keratitis. We would recommend extension of the current FDA testing panel for MPS to include more fungal isolates.
authors.affiliation: Department of Health Technology & Informatics, The Hong Kong Polytechnic University, Hong Kong SAR. htmboost@polyu.edu.hk
authors.forename: Maureen
authors.initials: M
authors.lastname: Boost
authors.forename: Sindy
authors.initials: S
authors.lastname: Lai
authors.forename: Cathy
authors.initials: C
authors.lastname: Ma
authors.forename: Pauline
authors.initials: P
authors.lastname: Cho
mesh_terms: D001419:Bacteria / Q000187:drug effects*; D002470:Cell Survival; D015169:Colony Count, Microbial; D003228:Conjunctiva / Q000382:microbiology; D018639:Contact Lens Solutions / Q000494:pharmacology*; D004202:Disinfectants / Q000494:pharmacology*; D005658:Fungi / Q000187:drug effects*; D006801:Humans; D008826:Microbial Sensitivity Tests; D013997:Time Factors
chemical_list: D018639:Contact Lens Solutions; D004202:Disinfectants