{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:18:30Z","timestamp":1792189110219,"version":"4.4.0"},"reference-count":53,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002908","name":"Stichting Combined Ophthalmic Research Rotterdam","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002908","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010378","name":"Stichting Wetenschappelijk Onderzoek Oogziekenhuis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010378","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"abstract":"Abstract<\/jats:title>\n \n Purpose<\/jats:title>\n \n Since 2015, the uncommon yet severe\n Acanthamoeba<\/jats:italic>\n keratitis (AK) and\n Fusarium<\/jats:italic>\n keratitis (FK) have increased in the Netherlands, predominantly in contact lens (CL) users. We investigated risk factors for acquisition and severity of AK and FK among CL users.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n For this retrospective case\u2013control study, we approached AK and FK cases diagnosed in 16 cornea reference centres between 2009 and 2019. CL\u2010wearing controls were recruited in 2020 through social media. Besides, we assessed risk factors for treatment failure (corneal transplantation and\/or final visual acuity \u22640.25) among cases included in the case\u2013control study. Odds ratios (OR) with 95% confidence intervals (95%CI) were computed in multivariable logistic regression analyses.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The case\u2013control study comprised 220 cases (181 AK, 39 FK) and 1020 controls. Identified risk factors were previous eye injury (OR: 16.0, 95%CI: 3.4\u201376.7), occupational\/recreational surface water contact (OR: 9.1, 95%CI: 3.5\u201323.2), cleaning\/rinsing CLs with tap water (OR: 3.3, 95%CI: 1.7\u20136.4), cigarette smoke exposure (OR: 1.9, 95%CI: 1.1\u20133.5) and napping in CLs (OR: 1.9, 95%CI: 1.0\u20133.6). Treatment failure occurred in 85\/179 (47%) AK and 23\/35 (66%) FK cases. Evisceration or enucleation was performed in 9\/179 (5%) AK and 5\/35 (14%) FK cases. Age\u2009>\u200942\u2009years (OR: 5.6, 95%CI: 2.3\u201314.6), hard CL use (OR: 3.3, 95%CI: 1.0\u201314.0), corticosteroid eye drops prior to diagnosis (OR: 3.8, 95%CI: 1.5\u201310.5) and a ring infiltrate at diagnosis (OR: 15.3, 95%CI: 4.8\u201357.4) were associated with AK treatment failure.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Identified preventable risks warrant enhanced communication between eye care providers and CL wearers promoting healthy CL wear and care practices. Increased awareness among ophthalmologists is needed to prevent corticosteroid treatment prior to AK diagnosis to reduce treatment failure.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/aos.70186","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:28:07Z","timestamp":1783052887000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk factors for acquisition and severity of\n Acanthamoeba<\/i>\n and\n Fusarium<\/i>\n keratitis in contact lens users\u2014A case\u2013control and clinical\u2013epidemiological study, 2009\u20132020"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1774-0975","authenticated-orcid":false,"given":"Laur\u00e8ne","family":"Peckeu\u2010Abboud","sequence":"first","affiliation":[{"name":"National Institute for Public Health and the Environment (RIVM) Bilthoven The Netherlands"},{"name":"ECDC Fellowship Programme Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC) Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6993-291X","authenticated-orcid":false,"given":"Anna C.","family":"Randag","sequence":"additional","affiliation":[{"name":"Rotterdam Eye Hospital Rotterdam The Netherlands"},{"name":"Rotterdam Ophthalmic Institute Rotterdam The Netherlands"},{"name":"Dutch Cornea Society of the Dutch Ophthalmological Society Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4130-6869","authenticated-orcid":false,"given":"Jeroen","family":"van Rooij","sequence":"additional","affiliation":[{"name":"Rotterdam Eye Hospital Rotterdam The Netherlands"},{"name":"Rotterdam Ophthalmic Institute Rotterdam The Netherlands"},{"name":"Dutch Cornea Society of the Dutch Ophthalmological Society Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0455-0336","authenticated-orcid":false,"given":"Dennis","family":"Souverein","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Infection Prevention Regional Public Health Laboratory Kennemerland Haarlem The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henny","family":"Otten","sequence":"additional","affiliation":[{"name":"Visser Contactlenzen Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2844-9868","authenticated-orcid":false,"given":"Robert P. L.","family":"Wisse","sequence":"additional","affiliation":[{"name":"Dutch Cornea Society of the Dutch Ophthalmological Society Nijmegen The Netherlands"},{"name":"Department of Ophthalmology University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5819-7569","authenticated-orcid":false,"given":"Claudy Oliveira","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Radboud University Medical Centre Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathrien A.","family":"Eggink","sequence":"additional","affiliation":[{"name":"Dutch Cornea Society of the Dutch Ophthalmological Society Nijmegen The Netherlands"},{"name":"Department of Ophthalmology Radboud University Medical Centre Nijmegen The 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