眼球摘除术后生理盐水冲洗的效果及不同抗菌剂对供体眼微生物污染的影响。

The efficacy of postenucleation saline wash and the effect of different antimicrobial agents on microbial contamination of donor eyes.

作者信息

Panda Anita, Saxena Rohit, Vajpayee Rasik B, Satpathy Gita, Angra S K, Sethi Harinder Singh

机构信息

Institute of Medical Sciences, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Ophthalmic Res. 2006;38(5):287-93. doi: 10.1159/000095772. Epub 2006 Sep 15.

DOI:10.1159/000095772

PMID:16974130

Abstract

OBJECTIVES

To evaluate the efficacy of postenucleation saline wash and the effect of different antimicrobial agents on the microbial contamination of donor eyes.

METHODS

Two hundred donor eyes were given saline wash and treated with any one of the following 5 randomly selected antimicrobial solutions: 1% povidone-iodine for 3 min, 0.3% gentamycin for 10 min, 0.3% ciprofloxacin for 10 min, a combination of neomycin 1,700 IU, gramicidin 0.025% and polymyxin B 5,000 IU (Neosporin(R)) for 10 min and a combination of 0.3% amikacin for 10 min, followed by 2.5% cefazolin for 10 min. Limbal swabs were sent for culture before and after saline wash and after treatment with antimicrobial agents.

RESULTS

On culture of the pretreatment swabs, 77.5% were positive for growth with 75.5% bacterial and 11.5% fungal. Coagulase-negative Staphylococcus (29.1%) was the most common bacterial contamination followed by Pseudomonas aeruginosa (18.5%), Acinetobacter sp. (18.5%) and Alcaligenes faecalis (13.2%). A 20-ml sterile saline wash resulted in a 20% decrease (p < 0.01) in the amount of contamination. The maximum antimicrobial effect with regard to bacterial decontamination was achieved with povidone-iodine (64% decrease in the amount of contamination, p < 0.01) followed by ciprofloxacin (47.6% decrease, p < 0.05), the combination of cefazolin and amikacin (42.5%, p < 0.05), Neosporin (38.5%, p < 0.05) and then gentamycin (21.7%, p = NS).

CONCLUSIONS

A thorough saline wash and treatment with 1% povidone-iodine for 3 min is a more effective method for the decontamination of donor eyes as compared to most currently available and frequently used antibiotics.

摘要

目的

评估眼球摘除术后生理盐水冲洗的效果以及不同抗菌剂对供体眼微生物污染的影响。

方法

对200只供体眼进行生理盐水冲洗，并用以下5种随机选择的抗菌溶液之一进行处理：1%聚维酮碘处理3分钟、0.3%庆大霉素处理10分钟、0.3%环丙沙星处理10分钟、新霉素1700 IU、短杆菌肽0.025%和多粘菌素B 5000 IU（新孢霉素）联合处理10分钟、0.3%阿米卡星联合2.5%头孢唑林处理10分钟。在生理盐水冲洗前、冲洗后以及抗菌剂处理后，采集角膜缘拭子进行培养。

结果

预处理拭子培养结果显示，77.5%有生长阳性，其中75.5%为细菌，11.5%为真菌。凝固酶阴性葡萄球菌（29.1%）是最常见的细菌污染菌，其次是铜绿假单胞菌（18.5%）、不动杆菌属（18.5%）和粪产碱菌（13.2%）。20毫升无菌生理盐水冲洗使污染量减少了20%（p < 0.01）。在细菌去污方面，聚维酮碘的抗菌效果最佳（污染量减少64%，p < 0.01），其次是环丙沙星（减少47.6%，p < 0.05）、头孢唑林和阿米卡星联合使用（42.5%，p < 0.05）、新孢霉素（38.5%，p < 0.05），然后是庆大霉素（21.7%，p =无统计学意义）。