da Costa Alexandre Xavier, Yu Maria Cecilia Zorat, de Freitas Denise, Cristovam Priscila Cardoso, LaMonica Lauren C, Dos Santos Vagner Rogerio, Gomes José Alvaro Pereira
Department of Ophthalmology and Visual Sciences, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
Transl Vis Sci Technol. 2020 Jun 5;9(7):7. doi: 10.1167/tvst.9.7.7. eCollection 2020 Jun.
To evaluate the impact of instillation angle and nozzle tip geometry on cross-contamination risk of multidose ocular solution bottles.
solution was passed exclusively on the outside of the nozzle to simulate contamination on the exterior of topical agents. Three drops were administered from angles of 90° and 45° from bottles with either a round or sharp tip geometry, and the cultures were examined for growth. Two-hundred sixteen cultures from nine lubricant eyedrop brands currently existing in the Brazilian market were assessed for bacterial growth.
After seven days, bacterial contamination was detected in 53.7% of cultures when drops were administered at 90° and in 70.4% of cultures at 45°. Eyedrops collected from a rounded nozzle tip and an instillation angle of 90° transmitted bacteria in 69.4% of cases, whereas those administered from a sharp tip transmitted bacteria in only 22.2% of cases ( = 0.001). At an instillation angle of 45°, contamination was identified in 83.3% of bottles with a rounded tip geometry and in only eight of 18 bottles (44.4%) from those with a sharp nozzle geometry ( = 0.005).
Adjusting the instillation angle of eyedrop solutions to 90°, as well as using a nozzle geometry that prevents flow of the solution to the side of the bottle, significantly reduced contamination rates.
Standardizing drop bottles and adjusting delivery angle shows promise in reducing contamination rates and may critically impact the quality of care for patients requiring topical therapeutic agents.
评估滴注角度和喷嘴尖端几何形状对多剂量眼药水瓶交叉污染风险的影响。
仅使溶液通过喷嘴外部，以模拟局部用药剂外部的污染情况。从具有圆形或尖锐尖端几何形状的瓶子中，分别以90°和45°的角度滴注三滴溶液，并检查培养物是否生长。对巴西市场上目前存在的九种润滑眼药水品牌的216份培养物进行细菌生长评估。
七天后，当以90°角度滴注时，53.7%的培养物检测到细菌污染；以45°角度滴注时，70.4%的培养物检测到细菌污染。从圆形喷嘴尖端且滴注角度为90°收集的眼药水中，69.4%的情况传播了细菌，而从尖锐尖端滴注的眼药水中，只有22.2%的情况传播了细菌（P = 0.001）。在滴注角度为45°时，83.3%的圆形尖端几何形状的瓶子中发现了污染，而在18个尖锐喷嘴几何形状的瓶子中，只有8个（44.4%）发现了污染（P = 0.005）。
将眼药水溶液的滴注角度调整为90°，以及使用可防止溶液流向瓶侧的喷嘴几何形状，可显著降低污染率。
标准化滴瓶并调整给药角度在降低污染率方面显示出前景，并且可能对需要局部治疗药物的患者的护理质量产生关键影响。
