Aeromonas caviae keratitis associated with contact lens wear

Objective: We report the first case of bilateral contact lens-related Aeromonas caviae keratitis associated with A. caviae contamination of the contact lens case. The presence of virulence factors produced by Aeromonas species was also investigated. Design: Case report. Intervention and Testing: Conjunctival swabs and corneal scrapings from both eyes were inoculated for culture. The contact lens case was also cultured. The isolate was analyzed for the presence of virulence properties, such as gelatinase and protease production. The presence of virulence genes, such as the cytolytic enterotoxin (AHCYTOEN) and type IV Aeromonas pilus (tap) genes, was investigated using polymerase chain reaction. The susceptibility of A. caviae to 6 commercial contact lens disinfecting solutions was tested. Main Outcome Measures: Culture results, protease activity, and gelatinase production were analyzed. Polymerase chain reaction amplification products were visualized in ethidium bromide-stained agarose gel. Bacterial growth after exposure to contact lens disinfecting solutions was assessed. Results: Aeromonas caviae was grown bilaterally from the conjunctiva, cornea, and contact lens case. The organism showed protease and gelatinase production. Polymerase chain reaction amplification revealed that the A. caviae strain contained the AHCYTOEN and tap virulence genes. Incubation for the minimum recommended time with all tested disinfecting solutions was effective in killing A. caviae. Conclusions: Aeromonas caviae should be considered a possible etiologic agent of contact lens-associated keratitis. The presence of virulence factors may be important in determining corneal infection. Commercial contact lens disinfecting solutions, along with proper lens case hygiene, may be effective in preventing A. caviae keratitis in soft contact lens wearers. (C) 2004 by the American Academy of Ophthalmology.