Binder C, de Kaspar H M, Engelbert M, Klauss V, Kampik A
Augenklinik, Ludwig-Maximilians-Universität München.
Ophthalmologe. 1998 Jun;95(6):438-41. doi: 10.1007/s003470050294.
Propionibacterium acnes has been described as a causative agent of postoperative endophthalmitis. This gram-positive, immotile, non-spore-forming bacterium is highly pleomorphic and grows under conditions of low to no oxygen concentration. It is commonly found on the skin at the openings of sebaceous glands and on hairs. A near-symptomless postoperative endophthalmitis occurs particularly when Propionibacteria are enclosed in the capsular bag. We investigated to what extent the number of P. acnes in the conjunctival sac can be reduced by preoperative disinfection with polyvidone iodine (1%).
A total of 261 patients with intrabulbar surgery had two conjuctival swabs taken: the first immediately prior to preoperative preparation in the operating theatre, following in-patient application of antibiotic eye drops (Polymyxin-B-sulfat, Neomycinsulfat and Gramicidin in combination); the second swab was taken after disinfection with polyvidone iodine before opening the conjunctiva.
Of the 261 swabs, 60 (23%) taken prior to polyvidone iodine application were positive for Propinibacterium acnes. Following polyvidone iodine treatment, a further 5 (1.9%) remained culture-positive. After disinfection, 55 (92%) of the 60 positive swabs for Propionibacterium acnes remained culture-negative.
We concluded that a significant reduction of P. acnes can be achieved by preoperative application of polyvidone iodine (1%) (P < 0.001).
痤疮丙酸杆菌已被描述为术后眼内炎的病原体。这种革兰氏阳性、不运动、不形成芽孢的细菌具有高度多形性，在低氧或无氧浓度条件下生长。它常见于皮脂腺开口处的皮肤和毛发上。当丙酸杆菌被包裹在囊袋中时，尤其会发生几乎无症状的术后眼内炎。我们研究了术前用1%聚维酮碘消毒能在多大程度上减少结膜囊中痤疮丙酸杆菌的数量。
共有261例接受眼球内手术的患者进行了两次结膜拭子采集：第一次在手术室术前准备前立即采集，此前患者已住院应用抗生素眼药水（硫酸多粘菌素B、硫酸新霉素和短杆菌肽联合使用）；第二次拭子在打开结膜前用聚维酮碘消毒后采集。
在261份拭子中，60份（23%）在应用聚维酮碘之前的痤疮丙酸杆菌检测呈阳性。聚维酮碘治疗后，另有5份（1.9%）培养仍为阳性。消毒后，60份痤疮丙酸杆菌阳性拭子中有55份（92%）培养为阴性。
我们得出结论，术前应用1%聚维酮碘可显著减少痤疮丙酸杆菌数量（P < 0.001）。
