Microbial Contamination of Soft Contact Lenses Among Medical School Students in Southern Iraq

Background: Contamination of CLs and accessories risks potentially devastating microbial keratitis. We aimed to explore the rate of microbial contamination and predisposing factors among a group of asymptomatic young medical students.Methodology: The study included 115 healthy female medical students with a mean age of 21.64 +/- 2.02 years between January and November 2021. Information about CL use, wear and care was gathered. Each participant's CL and case were swabbed for microbiological identification. Univariable and multivariable analyses were conducted to look for associations with a range of factors.Results: Overall, 91 participants (79.13%) had at least one contaminated sample (lens and/or case). The rates of contamination of CL and their cases were 66% and 76.5%, respectively. Higher contamination rates were caused by gram-negative bacteria (60% of the contaminated samples) with P. aeruginosa being the most common contaminant both for CL and cases, whereas S. epidermidis and S. aureus were the most common contaminants for the CL and cases, respectively, regarding gram-positive contamination. Multivariable analysis showed younger age as a significant predictor of pseudomonas contamination of the lenses and cases (OR: 12.302, 6.555 for CL & cases, respectively; P = 0.001 for both). Older age was a significant predictor of K. pneumoniae contamination (OR: 4.154, P = 0.007). Pseudomonas contamination of both lenses and cases was predicted by the type of solution used (OR: 10.8 and 13.5, P = 0.001 and 0.003 for bottled and distilled water vs commercially available solutions for CL; OR: 4.5 and 5.8, P = 0.045 and 0.004, respectively, for cases). Pseudomonas case contamination was associated with low frequency of solution change.Conclusion: Microbial contamination rate of soft CL and their cases is high among young medical students in comparison to previously reported rates and was predisposed by several poor hygienic practices and wearing regimens.