Leyden J J, McGinley K J, Kates S G, Myung K B
Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia.
Infect Control Hosp Epidemiol. 1989 Oct;10(10):451-4. doi: 10.1086/645920.
Methodologies for evaluating the efficacy of antimicrobial agents in the bacterial flora of the hand involve variations of the "glove juice" or "sterile bag" procedures. In this study we demonstrate that the subungual flora contribute significantly to the recovery of bacteria in these procedures. Culturing hands that had the subungual spaces sealed with acrylic polish demonstrated a decay type of curve for the number of bacteria recovered in successive samplings with 10(6) colony forming units (CFU) bacteria recovered in the first sampling and 10(3) in the sixth while the opposite hand on which the subungual spaces were not sealed demonstrated a continuous recovery of 10(6) CFU. Serial scrubbings of three minutes with plain detergent, 10% povidone-iodine or 4% chlorhexidine demonstrated a three logarithm reduction for povidone-iodine and four logarithm reduction compared to plain detergent alone for chlorhexidine in hands that had subungual spaces sealed, while the opposite hand showed only a 0.5 to 1.0 logarithm reduction. Povidone-iodine produced a 0.6 logarithm reduction and 4% chlorhexidine or 1.4 logarithm reduction in the density of subungual bacteria.
评估手部细菌菌群中抗菌剂疗效的方法涉及“手套汁液”或“无菌袋”程序的变体。在本研究中，我们证明了指甲下菌群在这些程序中对细菌的恢复有显著贡献。用丙烯酸指甲油密封指甲下间隙的手进行培养，连续采样中回收的细菌数量呈现出衰减型曲线，第一次采样回收10⁶个菌落形成单位（CFU）细菌，第六次采样回收10³个，而未密封指甲下间隙的对侧手则持续回收10⁶CFU。用普通洗涤剂、10%聚维酮碘或4%氯己定进行三分钟的连续擦洗，对于密封了指甲下间隙的手，聚维酮碘使细菌数量减少三个对数级，氯己定相比单独使用普通洗涤剂使细菌数量减少四个对数级，而对侧手仅减少0.5至1.0个对数级。聚维酮碘使指甲下细菌密度降低0.6个对数级，4%氯己定使指甲下细菌密度降低1.4个对数级。
