Bacterial interactions with contact lenses; effects of lens material, lens wear and microbial physiology

Contact lens wear is a successful form of vision correction. However, adverse responses can occur during wear. Many of these adverse responses are produced as a consequence of bacterial colonization of the lens. The present study demonstrated that during asymptomatic contact lens wear lenses are colonized by low levels of bacteria with gram-positive bacteria, such as coagulase negative staphylococci, predominating. Gram-negative bacteria are frequently the causative agents of adverse responses during contact lens wear. Measuring the adhesion of different strains and/or species of bacteria to different contact lens materials demonstrated considerable differences. In particular, Pseudomonas aeruginosa strains Paer1 and 6294 and Aeromonas hydrophilia strain Ahyd003 adhered in larger numbers to the highly oxygen permeable contact lenses Balafilcon A compared to hydrogel lenses manufactured from either Etafilcon A or HEMA. Furthermore, after Balafilcon A lenses had been worn for 6 h during the day bacteria were able to adhere in greater numbers to the worn lenses compared to the unworn lenses with increases in adhesion ranging from 243% to 1393%. However, wearing Etafilcon A lenses usually resulted in a decrease in adhesion (22–48%). Bacteria were able to grow after adhesion to lenses soaked in artificial tear fluid and formed biofilms, visualized by scanning confocal microscopy. Chemostat grown bacterial cultures were utilized to enable control of bacterial growth conditions and bacteria were shown to adhere in the greatest numbers if grown under low temperature (25°C compared to 37°C). The changes in growth temperature was shown, using 2D gel electrophoresis, to change the experssion of cell-surface proteins and, using 1D gel electrophoresis, to change the expression of surface lipopolysaccharide of P. aeruginosa Paer1. Thus, these surface changes would have been likely to have mediated the increased adhesion to Etafilcon A contact lenses.