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首页> 外文期刊>Eye & contact lens >Acanthamoeba: a review of its potential to cause keratitis, current lens care solution disinfection standards and methodologies, and strategies to reduce patient risk.
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Acanthamoeba: a review of its potential to cause keratitis, current lens care solution disinfection standards and methodologies, and strategies to reduce patient risk.

机译：棘阿米巴：回顾其引起角膜炎的潜力，当前的晶状体护理液消毒标准和方法以及降低患者风险的策略。

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BACKGROUND: The recent outbreaks of Acanthamoeba keratitis (AK), a rare but serious infection of the cornea, has increased the attention on the pathology of the organism and safety standards as they relate to soft contact lens (SCL) disinfection and solution formulations. OBJECTIVE: To review the pathologic potential of Acanthamoeba to produce keratitis in patients at risk, discuss the complex issues involved in Acanthamoeba SCL disinfection efficacy standards and testing methods, and present strategies for patients as well as governmental agencies to reduce the risk for future outbreaks of this organism. METHODS: Studies that investigated the pathology and occurrence of AK and the various methods for testing SCL disinfection products for efficacy against Acanthamoeba were reviewed and the results were summarized. RESULTS.: Acanthamoeba is a ubiquitous organism in nature and has pathogenic and nonpathogenic strains. Trophozoites--not cysts--bind to specific mannosylated proteins on the corneal surface abraded by SCL wear. These bound trophozoites produce a cytotoxic serine protease enzyme that destroys corneal integrity and provides the mechanism for Acanthamoeba to produce keratitis. To date, nowhere in the world are Acanthamoeba challenges included in product approval of SCL disinfection products. Nonstandardized microbiologic methods for SCL disinfection efficacy against Acanthamoeba continue to produce highly variable data from study to study. There are no detailed and standardized methods as yet for trophozoite cell culture, trophozoite-to-cyst conversion, product challenge with amoeba, neutralization of the test sample's antimicrobial activity, and accurate quantification of viable survivor cells. CONCLUSIONS: Reducing the incidence of AK is multifaceted and includes education of SCL wearers in the hygienic wear and care of their lenses, implementation of standardized and rigorous SCL solution disinfection requirements, and can also include improvements in the antimicrobial quality of municipal watersupplies.
机译：背景：近期爆发的棘阿米巴角膜炎（AK）是一种罕见但严重的角膜感染，已引起人们对机体病理学和安全标准的关注，因为它们涉及软性接触镜（SCL）消毒和溶液制剂。目的：审查棘阿米巴在有风险的患者中产生角膜炎的病理学潜力，讨论棘阿米巴SCL消毒功效标准和测试方法涉及的复杂问题，并为患者和政府机构提出降低未来爆发性阿米巴病风险的策略这种生物。方法：回顾了研究AK的病理和发生的研究，以及各种测试SCL消毒产品对棘阿米巴的有效性的方法，并对结果进行了总结。结果：棘阿米巴是自然界中普遍存在的生物，具有致病性和非致病性菌株。滋养体（不是囊肿）与SCL磨损磨损的角膜表面的特定甘露糖基化蛋白结合。这些结合的滋养体产生细胞毒性的丝氨酸蛋白酶，破坏了角膜的完整性，并为棘阿米巴产生角膜炎提供了机制。迄今为止，SCL消毒产品的产品批准中没有棘阿米巴挑战。 SCL对棘阿米巴的消毒的非标准化微生物方法继续在研究之间产生高度可变的数据。尚无用于滋养体细胞培养，滋养体向囊肿转化，变形虫对产品的挑战，中和测试样品的抗微生物活性以及活存活细胞准确定量的详细和标准化方法。结论：降低AK的发生率是多方面的，包括对SCL佩戴者进行卫生的佩戴和镜片护理方面的教育，对SCL解决方案进行标准化和严格的消毒要求，还可以包括改善市政供水的抗菌质量。

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