title: Bacterial biofilm diversity in contact lens-related disease: emerging role of Achromobacter, Stenotrophomonas, and Delftia.
abstract: OBJECTIVE
  Multi-species biofilms associated with contact lens cases and lenses can predispose individuals to contact lens-related inflammatory complications. Our study used culture-independent methods to assess the relationship between the severity of contact lens-related disease and bacteria residing in biofilms of contact lens cases and lenses.
  
  
  METHODS
  Contact lens cases and lenses from 28 patients referred to the West Virginia University Eye Institute and diagnosed as having mild keratitis, keratitis with focal infiltrates, or corneal ulcers were processed and evaluated for bacterial composition based on 16S ribosomal RNA gene sequencing. Cases and lenses from nine asymptomatic contact lens wearers were processed in a manner similar to controls. Relationships between disease severity, bacterial types, and bacterial diversity were evaluated statistically.
  
  
  RESULTS
  Disease severity and presenting visual acuity correlated with an increase in the diversity of bacterial types isolated from contact lens cases. A significant difference also was observed in the number of bacterial types associated with the three clinical groups. Achromobacter, Stenotrophomonas, and Delftia were prevalent in all disease groups, and Achromobacter and Stenotrophomonas were present in one asymptomatic control. Scanning electron microscopy revealed that Achromobacter and Stenotrophomonas formed a biofilm on the surface of contact lenses.
  
  
  CONCLUSIONS
  Culture-independent methods identified an association between disease severity and bacterial diversity in biofilms isolated from cases and lenses of patients with contact lens-related corneal disease. Achromobacter, Stenotrophomonas, and Delftia were predominant bacteria identified in our study, drawing attention to their emerging role in contact lens-related disease.
authors.affiliation: West Virginia University Eye Institute, West Virginia University, Morgantown, USA.
authors.forename: Lee
authors.initials: L
authors.lastname: Wiley
authors.forename: Dacie R
authors.initials: DR
authors.lastname: Bridge
authors.forename: Lee A
authors.initials: LA
authors.lastname: Wiley
authors.forename: J Vernon
authors.initials: JV
authors.lastname: Odom
authors.forename: Thomas
authors.initials: T
authors.lastname: Elliott
authors.forename: Joan C
authors.initials: JC
authors.lastname: Olson
mesh_terms: D042402:Achromobacter / Q000302:isolation & purification / Q000502:physiology / Q000648:ultrastructure; D000293:Adolescent; D000328:Adult; D018441:Biofilms; D003263:Contact Lenses, Hydrophilic / Q000382:microbiology*; D003320:Corneal Ulcer / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D004269:DNA, Bacterial / Q000032:analysis; D042742:Delftia / Q000302:isolation & purification / Q000502:physiology / Q000648:ultrastructure; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005260:Female; D006088:Gram-Negative Aerobic Bacteria / Q000302:isolation & purification / Q000502:physiology* / Q000648:ultrastructure; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012329:RNA, Bacterial / Q000235:genetics; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D020588:Stenotrophomonas / Q000302:isolation & purification / Q000502:physiology / Q000648:ultrastructure; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial; D012329:RNA, Bacterial; D012336:RNA, Ribosomal, 16S