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Bacterial biofilm in contactology: personal experiences

Stefano Palma1, Pier Enrico Gallenga1, Gian Luca Scoarughi3, Luciano Cerulli2
1Chieti University G. D’Annunzio, Chieti, Italy; 2Rome University Tor Vergata, Rome, Italy; 3Rome University La Sapienza, Rome, Italy

Lens colonization by bacterial biofilm may contribute to the pathogenesis of infectious keratitis ,the most significant complication associated with contact lens wear. Pseudomonas aeruginosa and secondary Staphylococcus epidermidis are the bacterial species most commonly implicated in CL-related eye infections, and both are capable to adhere to and to form biofilms on CL and on the inner walls of lens storage cases(1). Biofilms are aggregates of bacterial/microbial cells suspended within a matrix of extracellular material and firmly attached both to biotic and abiotic surfaces (2). The biofilm cells are phenotypically distinct from their planktonic counterparts, with peculiar gene-expression patterns and (in general) slower rates of metabolism leading to enhanced resistance to drug therapy, disinfectants, and the immune response of the host (2,3,4). Biofilms play an important role in the spread of antibiotic resistance (5). In contactology bacterial biofilm on CLs and/or CL storage cases reduces the efficacy of commonly used lens disinfectant systems and prolongs the pathogen’s contact with the surface of the eye, thus increasing its pathogenicity. Effective anti-biofilm strategies must necessarily take into account the biological mechanism of biofilm formation, the susceptibility to biofilm formation of different materials used to manufacture contact lenses and the efficacy of the lens care solutions. In order to evaluate theese arguments we compared the activity of different lens care solutions on planktonic and biofilm (or sessile) bacteria and the susceptibility of different contact lens materials (Silicone–hydrogel, SH; pHema; Phosphorylcoline-coated, PC-C) to biofilm formation by pseudomonas aeruginosa and staphylococcus epidermidis. Our findings indicate that hydrogen peroxide is more effective than others solutions against biofilm (6)and that the phosphorylcholine-coated surface of PC-C lens is more resistant to bacterial adhesion and colonization(7). The latter advantage could translate into more effective disinfection and a reduced risk of potentially serious CL-related eye infections.

(1) Henriques M, Sousa C, Lira M, Elisabete M, Oliveira R, Oliveira R, Azeredo J. Adhesion of Pseudomonas aeruginosa and Staphylococcus epidermidis to silicone-hydrogel contact lenses. Optom Vis Sci. 2005 82: 446-50
(2) Costerton JW, Montanaro L, Arciola CR. Biofilm in implant infections: its production and regulation. Int J Artif Organs. 2005 28:1062-8.
(3) Hoiby N, Krogh Johansen H, Moser C, Song Z, Ciofu O, Kharazmi A. Pseudomonas aeruginosa and the in vitro and in vivo biofilm mode of growth. Microbes Infect. 2001 3: 23-35.
(4) Selan L, Thaller MC, Berlutti F, Passariello C, Scazzocchio F, Renzini G. Effect of slime production on the antibiotic susceptibility of isolates from prosthetic infections. J Chemother. 1989 1: 369-73
(5) Gallenga PE, Carpineto P, Lobefalo L: Problemi farmacologici nella terapia anti-infettiva: gli antibiotici. Bollettino di aggiornamento in farmacologia oculare 5;1997
(6) Palma S. Zapelloni A., Nucci C., Mancino R., Cerulli L Interazione tra lenti a contatto e micro-organismi atti XVIII APIMO Congress, pag 191, Attualità in Oftalmologia.. di tuttto di più , Montecatini Terme 12-14 Aprile 1996; by Arbe ,Modena Italy
(7) Selan L., Palma S., Scoarughi GL, Papa R., Veeh R., Di Clemente D., Artini M. Phosphorylcoline impairs susceptibility to biofilm formation of hydrogel contact lenses Am.J. Ophthalmol 147(1) 134-9. Jan 2009 (Epub 2008 sep13)