RESUMO
Purpose: This study was conducted to evaluate and compare the in vitro disinfection efficacies of six commercial lens cleaning and disinfecting products for planned replacement soft contact lenses. Methods: Disinfection efficacies of five multi-purpose solutions (MPSs) and one hydrogen peroxide solution (HPS) as control were evaluated in the presence of organic soil according to the International Organization for Standardization (ISO, Geneva, Switzerland) ISO 14729 stand-alone test protocol. The five specified compendial organisms, three bacteria (Staphylococcus aureus, Pseudomonas aeruginosa, and Serratia marcescens) and two fungi (Candida albicans and Fusarium solani) were incubated with each solution under standard conditions, after which microbes were recovered and quantified. Results: Each of the solutions evaluated met or exceeded the standard's primary criteria (3-log reduction of bacteria and 1-log reduction of fungi) after incubation for the manufacturer-recommended soaking time, except for COMPLETE MPS, which achieved only 0.4 ± 0.1 average log reduction for C. albicans. However, differences in efficacy between the solutions were noted. Average log reduction across all microbes for Biotrue Hydration Plus (4.6 ± 0.1) was comparable to that for CLEAR CARE PLUS HPS (4.3 ± 0.1) and greater than those for OPTI-FREE puremoist (3.6 ± 0.1), OPTI-FREE Replenish (4.0 ± 0.2), ACUVUE RevitaLens (3.9 ± 0.03), and COMPLETE MPS (3.6 ± 0.1). Biotrue Hydration Plus was especially effective at reducing the population of C. albicans (4.2 ± 0.7-log reduction). Conclusion: Products marketed for planned replacement soft CL disinfection generally meet the ISO 14729 standard's primary criteria for reducing populations of compendial organisms, with larger differences between solutions noted with C. albicans.
RESUMO
BACKGROUND: Because corneal infiltrative events (CIEs) may result from bacterial components on contact lenses, which can come from contaminated lens cases, we evaluated the biocidal efficacy of five multipurpose solutions against Gram-negative commonly isolated and CIE-associated organisms. METHODS: Of the multipurpose solutions tested, one contained polyhexamethylene biguanide (PHMB)/polyquaternium-1 (PQ-1; Bausch & Lomb Incorporated: Biotrue), one contained alexidine dihydrochloride (alexidine)/PQ-1 (AMO: RevitaLens OcuTec) and three contained PQ-1/myristamidopropyl dimethylamine (MAPD; Alcon: Opti-Free PureMoist, PQ-1/MAPD-1; Opti-Free RepleniSH, PQ-1/MAPD-2; Opti-Free Express, PQ-1/MAPD-3). Challenge organisms were CIE-associated Achromobacter xylosoxidans, Delftia acidovorans and Stenotrophomonas maltophilia at manufacturer-recommended durations (stand-alone), in lens cases without lenses (up to seven days) and in lens cases with etafilcon A lenses (up to 30 days). RESULTS: In stand-alone testing against CIE-associated organisms, PHMB/PQ-1 and alexidine/PQ-1 were significantly superior versus MAPD-based multipurpose solutions against A. xylosoxidans (all p ≤ 0.01), D. acidovorans (all p ≤ 0.001) and S. maltophilia (all p ≤ 0.05). In lens cases, PHMB/PQ-1 and alexidine/PQ-1 achieved greater than 3-log reductions against all challenge organisms at all times evaluated. PQ-1/MAPD-1 achieved a greater than 3-log reduction against D. acidovorans at 24 hours; PQ-1/MAPD-1 and PQ-1/MAPD-3 achieved greater than 3-log reductions at seven days against all organisms. In lens cases with lenses, PHMB/PQ-1 and alexidine/PQ-1 achieved greater than 3-log reductions against all organisms at all times. PQ-1/MAPD-1 and PQ-1/MAPD-3 achieved greater than 3-log reductions at seven or more days against all organisms. PQ-1/MAPD-2 did not achieve a greater than 3-log reduction at any time; some regrowth was observed. CONCLUSIONS: PHMB- and alexidine-based multipurpose solutions demonstrated significantly greater biocidal activity compared with PQ-1/MAPD-based agents against Gram-negative organisms commonly isolated and CIE-associated pathogens.
