Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania.
Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania.
Am J Ophthalmol. 2014 Mar;157(3):514-8.e1. doi: 10.1016/j.ajo.2013.10.003. Epub 2013 Oct 19.
To report conjunctival bacterial flora antibiotic resistance patterns after serial intravitreal injections performed using a povidone-iodine preparation without the use of preinjection or postinjection topical antibiotics.
Prospective, interventional case series.
Single-center clinical practice in Pennsylvania.
Thirteen eyes of 13 treatment-naïve patients undergoing serial intravitreal anti-vascular endothelial growth factor (VEGF) injections for exudative age-related macular degeneration or macular edema attributable to retinal vein occlusion.
Conjunctival cultures from the treatment eye were performed prior to each injection preparation. A minimum of 3 monthly conjunctival cultures were obtained per eye over the course of the study. Ocular surface preparation consisted of topical anesthetic and povidone-iodine 5% without the use of preinjection or postinjection topical antibiotics.
Conjunctival flora growth patterns and antibiotic resistance patterns to several common antibiotics tested over the course of the study.
A total of 48 cultures were performed with a 77% culture positivity rate. Over the course of the serial conjunctival cultures in each patient, there was no evidence for emergence of resistant bacteria to any of the tested antibiotics (including fluoroquinolones and azithromycin) or significant alteration from baseline conjunctival flora. Of the 47 bacterial isolates, the most commonly isolated organism was coagulase-negative Staphylococcus both at baseline (73%) and following serial intravitreal injections (78%, P = .73).
Ocular surface preparation for intravitreal injection using povidone-iodine 5% alone in the absence of postinjection topical antibiotics does not appear to promote bacterial resistance or a discernible change in conjunctival flora.
报告在不使用注射前或注射后局部抗生素的情况下，使用聚维酮碘制剂进行连续玻璃体内注射后结膜细菌菌群的抗生素耐药模式。
前瞻性、干预性病例系列。
宾夕法尼亚州的单中心临床实践。
13 名未经治疗的患者的 13 只眼，这些患者因渗出性年龄相关性黄斑变性或视网膜静脉阻塞引起的黄斑水肿，接受连续玻璃体内抗血管内皮生长因子（VEGF）注射治疗。
在每次注射准备前对治疗眼的结膜进行培养。在研究过程中，每只眼至少获得 3 次每月的结膜培养。眼部表面准备包括局部麻醉和 5%聚维酮碘，不使用注射前或注射后局部抗生素。
在研究过程中测试的几种常见抗生素的结膜菌群生长模式和抗生素耐药模式。
共进行了 48 次培养，培养阳性率为 77%。在每个患者的连续结膜培养过程中，没有证据表明任何测试抗生素（包括氟喹诺酮类和阿奇霉素）出现耐药菌，也没有明显改变基线结膜菌群。在 47 个细菌分离株中，最常见的分离物是凝固酶阴性葡萄球菌，无论是在基线（73%）还是在连续玻璃体内注射后（78%，P=.73）。
单独使用 5%聚维酮碘进行玻璃体内注射的眼部表面准备，不使用注射后局部抗生素，似乎不会促进细菌耐药性或结膜菌群的明显变化。
