title: [Preoperative infection prophylaxis with 1% polyvidon-iodine solution based on the example of conjunctival staphylococci].
abstract: BACKGROUND
  Most germs causing postoperative endophthalmitis derive from the conjunctival bacterial normal flora. Postoperative endophthalmitis is often induced by staphylococcal germs. The application of polyvidone-iodine solution to the conjunctiva is one possibility to reduce potential endophthalmitis-causing bacteria. The aim of this study was to evaluate the effectiveness of 1% polyvidone-iodine solution concerning the reduction of colonization with staphylococci in the course of intraocular surgery. This is to evaluate the effectiveness of 1% polyvidone-iodine solution concerning coagulase-negative and positive staphylococci.
  
  
  METHODS
  Patients with intrabulbar surgery (300) had three conjunctival 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 antisepsis with polyvidone-iodine before opening the conjunctiva. At the end of surgery the third smear was taken.
  
  
  RESULTS
  In 30.3% staphylococci were isolated from eyes before disinfection. Some patients (7.7%) were staphylococci-positive after disinfection; 5.3% of the patients showed staphylococcal growth at the end of surgery. To evaluate the effectiveness of polyvidone-iodine 1% solution we compared the first and the second smear (Mc Nemar). We found a statistically significant reduction (P < 0.001). At the end of surgery the conjunctival colonization with staphylococcal germs remained statistically significant reduced (P < 0.001). The mean operation time was 37 +/- 24 min.
  
  
  CONCLUSIONS
  We concluded that a significant reduction of a staphylococcal colonization can be achieved by preoperative application of polyvidone-iodine (1%) (P < 0.001). Even at the end of surgery the effect of 1% polyvidone-iodine solution held.
authors.affiliation: Universitäts-Augenklinik, München.
authors.forename: C A
authors.initials: CA
authors.lastname: Binder
authors.forename: H
authors.initials: H
authors.lastname: Miño de Kaspar
authors.forename: V
authors.initials: V
authors.lastname: Klauss
authors.forename: A
authors.initials: A
authors.lastname: Kampik
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000494:pharmacology / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D003228:Conjunctiva / Q000382:microbiology*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D009877:Endophthalmitis / Q000517:prevention & control*; D006096:Gramicidin / Q000627:therapeutic use; D006801:Humans; D009355:Neomycin / Q000627:therapeutic use; D009883:Ophthalmic Solutions; D013508:Ophthalmologic Surgical Procedures; D011112:Polymyxin B / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control*; D011206:Povidone-Iodine / Q000494:pharmacology / Q000627:therapeutic use*; D011292:Premedication; D012189:Retrospective Studies; D012996:Solutions; D013210:Staphylococcus / Q000187:drug effects* / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D009883:Ophthalmic Solutions; D012996:Solutions; D006096:Gramicidin; D011206:Povidone-Iodine; D009355:Neomycin; D011112:Polymyxin B