Hendley J O, Ashe K M
Department of Pediatrics, University of Virginia Health Sciences Center, Charlottesville 22908.
Antimicrob Agents Chemother. 1991 Apr;35(4):627-31. doi: 10.1128/AAC.35.4.627.
The efficacy of antimicrobial agents applied topically to the skin surface in eradicating coagulase-negative staphylococci (CNS) residing in the stratum corneum underlying the surface was examined. Glabrous skin was sampled with a 26-cm2 contact plate containing Trypticase soy agar. Five antiseptic solutions and four antimicrobial ointments were evaluated. The antiseptic solutions (10% povidone-iodine, 2% aqueous iodine, 2% tincture of iodine, 70% ethanol, and 0.5% chlorhexidine-ethanol) were applied for 15 s with a gauze sponge. The antimicrobial ointments (iodophor, silver sulfadiazine, mupirocin, and a triple-antibiotic ointment containing neomycin, polymyxin, and bacitracin) were applied and covered for 6 h with gauze. After treatment, the surface was sampled, 15 to 25 keratinized layers were subsequently removed by sequential stripping with cellophane tape, and the stratum corneum was sampled. All agents were effective in eradicating CNS from the surface (80 of 88 trials). However, only 2% iodine (17 of 20 trials), iodophor (8 of 12), mupirocin (6 of 10), and the triple-antibiotic ointment (9 of 11) eradicated CNS from the stratum corneum reliably (greater than or equal to 50% of trials). The stratum corneum was repopulated with resident flora within 24 h of treatment with 2% iodine (4 of 4 trials), iodophor (6 of 7), or mupirocin (5 of 6), but repopulation occurred in only 1 of 7 trials with the triple-antibiotic ointment. Topical treatment of skin with antimicrobial agents usually eradicates CNS from the skin surface but may not eradicate CNS from the stratum corneum. Only the triple-antibiotic ointment eradicated CNS from the stratum corneum and prevented repopulation with resident flora.
研究了局部应用于皮肤表面的抗菌剂对清除皮肤表面下角质层中凝固酶阴性葡萄球菌（CNS）的效果。用一块含有胰蛋白酶大豆琼脂的26平方厘米接触平板对无毛皮肤进行采样。评估了五种防腐剂溶液和四种抗菌软膏。用纱布海绵将防腐剂溶液（10%聚维酮碘、2%碘水溶液、2%碘酊、70%乙醇和0.5%氯己定乙醇）涂抹15秒。将抗菌软膏（碘伏、磺胺嘧啶银、莫匹罗星和一种含有新霉素、多粘菌素和杆菌肽的三联抗生素软膏）涂抹并用纱布覆盖6小时。治疗后，对皮肤表面进行采样，随后用玻璃纸胶带依次剥离去除15至25层角质化层，并对角质层进行采样。所有药物在清除皮肤表面的CNS方面均有效（88次试验中有80次）。然而，只有2%碘（20次试验中有17次）、碘伏（12次试验中有8次）、莫匹罗星（10次试验中有6次）和三联抗生素软膏（11次试验中有9次）能可靠地清除角质层中的CNS（试验次数大于或等于50%）。在用2%碘（4次试验中有4次）、碘伏（7次试验中有6次）或莫匹罗星（6次试验中有5次）治疗后的24小时内，角质层被常驻菌群重新定植，但三联抗生素软膏治疗的7次试验中只有1次出现重新定植。用抗菌剂对皮肤进行局部治疗通常能清除皮肤表面的CNS，但可能无法清除角质层中的CNS。只有三联抗生素软膏能清除角质层中的CNS并防止常驻菌群重新定植。
