Lucci L M, Yu M C, Höfling-Lima A L
Department of Ophthalmology, Federal University of São Paulo, Brazil.
Cornea. 1999 Sep;18(5):595-8.
The human sclera is frequently used in ophthalmic surgeries and must be preserved in disinfectants that prevent its contamination. In this study the efficiency of glycerin, absolute alcohol (ethanol), and benzalkonium chloride (1:5,000) as human sclera disinfectants were compared.
Fresh human scleras were trephined, the scleral disks divided into three groups and contaminated with Staphylococcus aureus (ATCC 29213), Pseudomonas aeruginosa (ATCC 27853), or Bacillus cereus (ATCC 11778) for 24 h. Thereafter they were transferred to preservation vials each containing glycerin, absolute alcohol, benzalkonium chloride diluted in 70% alcohol (1:5,000) or Trypticase Soy Broth (control), respectively, and stored at room temperature. From each vial, two scleral disks were removed after 1, 2, 3, 4, 7, 10, and 14 days of immersion. Both were plated on blood agar, one being macerated, and both incubated at 37 degrees C for 48 h.
Pseudomonas aeruginosa, S. aureus, and B. cereus were recovered from the glycerin-immersed scleral disks until the second, fourth, and fourteenth days, respectively. Bacillus cereus was recovered from those immersed in absolute alcohol until the fourteenth day, whereas disks infected with the other microorganisms and immersed in absolute alcohol presented no growth since the very first day of immersion. Bacillus cereus was recovered from scleral disks immersed in benzalkonium chloride diluted in 70% alcohol (1:5,000) only on the first day.
Resistant microorganisms can survive in scleral tissue preserved in glycerin and absolute alcohol. We conclude that benzalkonium chloride diluted in 70% alcohol (1:5,000) in vitro is the best disinfectant for human sclera after 24 h.
人巩膜常用于眼科手术,必须保存在能防止其污染的消毒剂中。本研究比较了甘油、无水乙醇(乙醇)和苯扎氯铵(1:5000)作为人巩膜消毒剂的效果。
将新鲜人巩膜环切,将巩膜盘分成三组,分别用金黄色葡萄球菌(ATCC 29213)、铜绿假单胞菌(ATCC 27853)或蜡样芽孢杆菌(ATCC 11778)污染24小时。之后,将它们分别转移到含有甘油、无水乙醇、70%酒精稀释的苯扎氯铵(1:5000)或胰蛋白胨大豆肉汤(对照)的保存瓶中,并在室温下储存。在浸泡1、2、3、4、7、10和14天后,从每个瓶中取出两个巩膜盘。将两者接种在血琼脂平板上,其中一个进行研磨,两者均在37℃下培养48小时。
分别在第二天、第四天和第十四天从甘油浸泡的巩膜盘中检出铜绿假单胞菌、金黄色葡萄球菌和蜡样芽孢杆菌。在第十四天之前,从无水乙醇浸泡的巩膜盘中检出蜡样芽孢杆菌,而感染其他微生物并浸泡在无水乙醇中的巩膜盘从浸泡第一天起就没有生长。仅在第一天从浸泡在70%酒精稀释的苯扎氯铵(1:5000)中的巩膜盘中检出蜡样芽孢杆菌。
耐药微生物能在甘油和无水乙醇保存的巩膜组织中存活。我们得出结论:体外70%酒精稀释的苯扎氯铵(1:5000)是24小时后人巩膜的最佳消毒剂。