Binder C A, Miño de Kaspar H, Klauss V, Kampik A
Universitäts-Augenklinik, München.
Ophthalmologe. 1999 Oct;96(10):663-7. doi: 10.1007/s003470050471.
Most germs causing postoperative endophthalmitis derive from the conjunctival bacterial normal flora. Postoperative endophthalmitis is often induced by staphylococcal germs. The application of polyvidone-iodine solution to the conjunctiva is one possibility to reduce potential endophthalmitis-causing bacteria. The aim of this study was to evaluate the effectiveness of 1% polyvidone-iodine solution concerning the reduction of colonization with staphylococci in the course of intraocular surgery. This is to evaluate the effectiveness of 1% polyvidone-iodine solution concerning coagulase-negative and positive staphylococci.
Patients with intrabulbar surgery (300) had three conjunctival swabs taken: the first immediately prior to preoperative preparation in the operating theatre, following in-patient application of antibiotic eye drops (Polymyxin-B-sulfat, Neomycinsulfat and Gramicidin in combination); the second swab was taken after antisepsis with polyvidone-iodine before opening the conjunctiva. At the end of surgery the third smear was taken.
In 30.3% staphylococci were isolated from eyes before disinfection. Some patients (7.7%) were staphylococci-positive after disinfection; 5.3% of the patients showed staphylococcal growth at the end of surgery. To evaluate the effectiveness of polyvidone-iodine 1% solution we compared the first and the second smear (Mc Nemar). We found a statistically significant reduction (P < 0.001). At the end of surgery the conjunctival colonization with staphylococcal germs remained statistically significant reduced (P < 0.001). The mean operation time was 37 +/- 24 min.
We concluded that a significant reduction of a staphylococcal colonization can be achieved by preoperative application of polyvidone-iodine (1%) (P < 0.001). Even at the end of surgery the effect of 1% polyvidone-iodine solution held.
大多数引起术后眼内炎的病菌源自结膜正常菌群中的细菌。术后眼内炎常由葡萄球菌属病菌引发。向结膜应用聚维酮碘溶液是减少潜在致眼内炎细菌的一种方法。本研究的目的是评估1%聚维酮碘溶液在眼内手术过程中减少葡萄球菌定植的有效性。这是为了评估1%聚维酮碘溶液对凝固酶阴性和阳性葡萄球菌的有效性。
进行眼球内手术的患者（300例）取三次结膜拭子：第一次在手术室术前准备前即刻采集，之后住院应用抗生素眼药水（多粘菌素B硫酸盐、新霉素硫酸盐和短杆菌肽联合使用）；第二次拭子在打开结膜前用聚维酮碘消毒后采集。手术结束时采集第三次涂片。
消毒前从眼部分离出葡萄球菌的患者占30.3%。部分患者（7.7%）消毒后葡萄球菌呈阳性；5.3%的患者在手术结束时出现葡萄球菌生长。为评估1%聚维酮碘溶液的有效性，我们比较了第一次和第二次涂片（麦克尼马尔检验）。我们发现有统计学意义的减少（P < 0.001）。手术结束时，结膜葡萄球菌属病菌定植仍有统计学意义的减少（P < 0.001）。平均手术时间为37 ± 24分钟。
我们得出结论，术前应用1%聚维酮碘可显著减少葡萄球菌定植（P < 0.001）。即使在手术结束时，1%聚维酮碘溶液的效果依然存在。
