Der Ophthalmologe

, Volume 109, Issue 8, pp 782–787

Bakterielle Kontamination von Injektionskanülen nach intravitrealer operativer Medikamenteneingabe in Paraguay

  • J.C. Gines
  • M.M. Nentwich
  • A.H. Peggy Bedoya
  • P. Cibils
  • A. Esteche
  • F. Laspina
  • M. Samudio
  • N. Fariña
  • H.M. de Kaspar
Originalien

Zusammenfassung

Hintergrund

Prospektive Untersuchung der bakteriellen Kontamination für die intravitreale operative Medikamenteneingabe (IVOM) verwendeter Injektionskanülen.

Material und Methoden

Zwischen 12/2007 und 12/2010 wurden in der Fundación Visión, Asunción, Paraguay 549 Augen von 413 Patienten intravitreal mit Bevacizumab 1,25 mg behandelt: 322 Patienten erhielten eine, 91 Patienten mehrfache Behandlungen. Vor dem Eingriff erfolgte bei allen Patienten eine periorbitale Desinfektion mit 10% Povidon-Jod (PVI) sowie eine Spülung des Bindehautsackes mit 10 ml 1% PVI. Antibiotika wurden präoperativ nicht gegeben. Unmittelbar nach der IVOM wurden die Kanülen 3-mal in Thioglycolat-Nährlösung gespült, die anschließend 5 Tage lang bei 37°C kultiviert wurde. Als Negativkontrolle dienten 73 unbenutzte Kanülen, die auf dieselbe Weise gespült und kultiviert wurden.

Ergebnisse

Acht der untersuchten 549 (1,45%) Kanülen waren nach der IVOM bakteriell kontaminiert. Die identifizierten Bakterien waren: koagulasenegative Staphylococcus (n = 7), Propionibacterium acnes (n = 1) und Klebsiella pneumoniae (n = 1; Kokontamination bei einer Kanüle).

Schlussfolgerung

Nach präoperativer PVI-Desinfektion fanden wir eine niedrige Rate kontaminierter Injektionskanülen. Zur Prävention postoperativer Infektionen empfehlen wir daher eine sorgfältig Prophylaxe mit PVI.

Schlüsselwörter

Intravitreale operative Medikamenteneingabe Intravitreale Therapie Präoperative Prophylaxe Bakterielle Kontamination Mikrobiologie 

Bacterial contamination of needles after intravitreal injection in Paraguay

Abstract

Purpose

The study was designed to prospectively evaluate the bacterial contamination of needles used for intravitreal injection during surgery.

Material and methods

Between December 2007 and December 2010, 549 eyes of 413 patients were treated with intravitreal injections of 1.25 mg bevacizumab. Of the patients 322 received a single injection and 91 multiple injections. Preoperatively the periorbital skin of all patients was treated with 10% povidone iodine (PVI) and the conjunctival sac was irrigated with 1% PVI. No pre-injection antibiotics were administered. Immediately after the injection the needles were rinsed 3 times in thioglycolate broth which was then cultured at 37°C for 5 days. As a negative control 73 sterile unused needles were treated in the same way.

Results

Out of the 549 needle points tested 8 (1,45%) were found to be contaminated after intravitreal injections. The isolated bacteria were coagulase negative Staphylococcus (n = 7), Propionibacterium acnes (n = 1) and Klebsiella pneumoniae (n = 1) (co-contamination in one case).

Conclusion

Contamination of needles is minimal after prophylactic povidone iodine irrigation before intravitreal injections. Therefore, this prophylaxis technique is recommended before intravitreal injections in order to prevent postoperative infections.

Keywords

Intravitreal injections Intravitreal therapy Preoperative prophylaxis Bacterial contamination Microbiology 

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • J.C. Gines
    • 1
    • 2
  • M.M. Nentwich
    • 1
  • A.H. Peggy Bedoya
    • 1
    • 2
    • 3
  • P. Cibils
    • 2
    • 3
  • A. Esteche
    • 2
  • F. Laspina
    • 4
  • M. Samudio
    • 4
  • N. Fariña
    • 4
  • H.M. de Kaspar
    • 1
  1. 1.Augenklinik der LMUKlinikum der Universität München, Campus InnenstadtMünchenDeutschland
  2. 2.Fundación VisiónAsunciónParaguay
  3. 3.Department of OphthalmologyNational University of AsunciónAsunciónParaguay
  4. 4.Instituto de Investigaciones en Ciencias de la SaludUniversidad Nacional de AsunciónAsunciónParaguay

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