Choudhuri M, McQueen R, Inoue S, Gordon R C
Department of Pediatrics, Hurley Medical Center, Flint, MI 48502.
Am J Infect Control. 1990 Apr;18(2):82-5. doi: 10.1016/0196-6553(90)90086-8.
Skin sterilization for a venipuncture is routinely done with commercially available alcohol or iodine pads. Selection of the antiseptics, alcohol or iodine, however, in most situations has been made on the basis of very little scientific data. With many patients with granulocytopenia who are undergoing venipunctures, the choice of antiseptic may be an important factor in preventing infections. We investigated two widely and commercially available disinfectant pads, alcohol and iodine, in the efficacy of skin sterilization. Seventy subjects (35 adults and 35 children) were randomly selected for this study. A designated area of the right and left forearm was sterilized either with alcohol or with an iodine pad in a predetermined uniform fashion. Specimens were obtained for cultures before and after sterilization. The bacterial cultures were performed with the use of blood agar plates and trypticase soy broth. For data analysis growth of any organisms on agar plates or trypticase soy broth after sterilization was interpreted as a sterilization failure. The iodine swab was significantly more efficient than the alcohol swab; the former yielded an 80% sterilization rate whereas the latter resulted in a rate of 61% (p less than 0.02). If, however, the growth only in agar plates was compared, the alcohol wipe yielded no growth in 83% and iodine in 84%, virtually identical success rates. Bacillus spp. predominated the residual organisms after either the alcohol or the iodine wipe. A variety of other organisms, however, including Staphylococcus and Corynebacterium spp., grew after alcohol but not after iodine sterilization.(ABSTRACT TRUNCATED AT 250 WORDS)
静脉穿刺时的皮肤消毒通常使用市售的酒精或碘伏棉片。然而，在大多数情况下，对于酒精或碘伏等防腐剂的选择，所依据的科学数据非常少。对于许多正在接受静脉穿刺的粒细胞减少症患者来说，防腐剂的选择可能是预防感染的一个重要因素。我们研究了两种广泛使用且市售的消毒棉片，酒精和碘伏，在皮肤消毒效果方面的差异。本研究随机选取了70名受试者（35名成人和35名儿童）。左右前臂的指定区域分别用酒精或碘伏棉片以预定的统一方式进行消毒。在消毒前后获取标本进行培养。使用血琼脂平板和胰蛋白酶大豆肉汤进行细菌培养。数据分析时，消毒后琼脂平板或胰蛋白酶大豆肉汤上有任何微生物生长都被判定为消毒失败。碘伏擦拭明显比酒精擦拭更有效；前者的消毒率为80%，而后者为61%（p小于0.02）。然而，如果仅比较琼脂平板上的生长情况，酒精擦拭后无生长的比例为83%，碘伏为84%，成功率几乎相同。酒精或碘伏擦拭后，残留微生物中芽孢杆菌属占主导。然而，包括葡萄球菌属和棒状杆菌属在内的多种其他微生物，在酒精消毒后生长，但在碘伏消毒后不生长。（摘要截短于250字）
