title: Microbial contamination of contact lens care accessories and compliance with care regimens in Nepal.
abstract: OBJECTIVE
  To determine the rates of microbial contamination and identify contaminants associated with contact lens (CL) care accessories. To investigate self-reported compliance levels with care of CL accessories and its association with contamination level.
  
  
  METHODS
  A total of 46 CL cases and care solutions from asymptomatic soft contact lens wearers were collected. Samples from the CL cases and care solutions were cultured for microbiological identification and enumeration. A questionnaire regarding compliance to care and hygiene procedures were administered to each subject on their visit.
  
  
  RESULTS
  The percentage of microbial contamination for CL cases and care solutions was 50% and 10.9%, respectively. All the contaminants were bacterial. Staphylococcus aureus (37.0%, 17 of 46 cases) and Escherichia coli (8.7%, 4 of 46 cases) were the most common microorganisms detected in CL cases. In care solutions, S. aureus (8.7%, 4 of 46 samples), Pseudomonas aeruginosa (2.2%, 1 of 46 samples) were common contaminants. CL cases and care solutions that were used for <3 months were significantly less contaminated than those used for >3 months (10.9% versus 39.1%, p<0.05). Polyquad and Aldox based MPS solution showed no contamination. Subjects with medium or low compliance had highly significant rates of contaminations both in CL cases and solutions than for subjects with high compliance (p<0.05).
  
  
  CONCLUSIONS
  Nepalese Soft CL wearers are at high risk of developing ocular complications due to high CL case and solution contamination. Frequent replacement of CL cases and solutions, as well as good compliance is recommended to reduce risk of contamination.
authors.affiliation: College of Optometry, University of Houston, Houston, TX, USA. Electronic address: SPanthi@optometry.uh.edu.
authors.forename: Shyam
authors.initials: S
authors.lastname: Panthi
authors.affiliation: Brien Holden Vision Institute, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Prakash
authors.initials: P
authors.lastname: Paudel
authors.affiliation: B.P. Koirala Lions Center for Ophthalmic Studies, Tribhuvan University, Kathmandu, Nepal.
authors.forename: Meenu
authors.initials: M
authors.lastname: Chaudhary
authors.affiliation: Nepal Eye Hospital, Kathmandu, Nepal.
authors.forename: Kishor
authors.initials: K
authors.lastname: Sapkota
authors.affiliation: B.P. Koirala Lions Center for Ophthalmic Studies, Tribhuvan University, Kathmandu, Nepal.
authors.forename: Dev N
authors.initials: DN
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D000328:Adult; D001419:Bacteria / Q000302:isolation & purification*; D001431:Bacteriological Techniques; D018639:Contact Lens Solutions; D003263:Contact Lenses, Hydrophilic / Q000382:microbiology*; D004340:Drug Contamination / Q000706:statistics & numerical data*; D004866:Equipment Contamination / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009390:Nepal; D054158:Orthokeratologic Procedures / Q000295:instrumentation*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D018639:Contact Lens Solutions
keywords: Bacteria; Compliance; Contact lens cases; Microbial contamination