title: Phacoemulsificator and sterile drapes contamination during cataract surgery: a microbiological study.
abstract: OBJECTIVE
  To determine the microbial contamination of the irrigating fluids at the time of phacoemulsification after the use of topical povidone-iodine and antibiotics prophylaxis.
  
  
  METHODS
  A total of 119 patients undergoing cataract surgery were enrolled in this prospective study. All patients received 5 mg/mL levofloxacin starting from the day prior to surgery and topical and 5% povidone-iodine drops starting from 30 minutes before the surgery. At the end of each surgery, 2 samples of drainage liquids were sterilely collected from the drainage bags (DBL) and from the peristaltic pump single-cassettes (PCL) of the phacoemulsification machine. Search for aerobic and anaerobic bacteria and fungi was performed.
  
  
  RESULTS
  Seventy-five patients (31.5%) revealed a growth of at least one microbial species (53 DBL and 22 PCL, 44.5% vs 18.5%; p<0.001). Sixty-six patients (55.5%) had at least one positive intraoperative solution. Overall, 111 microbial strains were collected: 82 (74%) Gram-positive bacteria, 20 (18%) fungi, and 9 (8%) Gram-negative bacteria. Thirteen staphylococcal isolates from PCL, compared with 52 out of DBL (11% vs 43.7%, p<0.001), fungi were essentially isolated from PCL. No significant correlation was found between microbial isolation and risk factors. No postsurgical infective complication occurred in the follow-up.
  
  
  CONCLUSIONS
  Evaluation of intraoperative fluids can provide evidence on sources or vehicles of postsurgical infections. Antibiotic prophylaxis and topical povidone-iodine can significantly contribute to minimize the risk of endophthalmitis.
authors: Department of Ophthalmology and Neurosurgery, University of Siena, Siena, Italy. balestrazzi@unisi.it
authors: Angelo
authors: A
authors: Balestrazzi
authors: Alex
authors: A
authors: Malandrini
authors: Francesca
authors: F
authors: Montagnani
authors: Ghislaine Laure
authors: GL
authors: Nguisseu Chegoua
authors: Leonardo
authors: L
authors: Ciompi
authors: Alessandra
authors: A
authors: Zanchi
authors: Gian Marco
authors: GM
authors: Tosi
authors: Gian Luca
authors: GL
authors: Martone
authors: Ilaria
authors: I
authors: Motolese
authors: Mario
authors: M
authors: Fruschelli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis; D001419:Bacteria / Q000302:isolation & purification*; D015169:Colony Count, Microbial; D009877:Endophthalmitis / Q000382:microbiology / Q000517:prevention & control; D004866:Equipment Contamination; D005260:Female; D005658:Fungi / Q000302:isolation & purification*; D006801:Humans; D064704:Levofloxacin; D008297:Male; D015242:Ofloxacin / Q000627:therapeutic use; D009883:Ophthalmic Solutions; D018918:Phacoemulsification / Q000295:instrumentation*; D011206:Povidone-Iodine / Q000008:administration & dosage; D011446:Prospective Studies; D012307:Risk Factors; D058636:Surgical Drapes / Q000382:microbiology*; D007507:Therapeutic Irrigation
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D009883:Ophthalmic Solutions; D064704:Levofloxacin; D011206:Povidone-Iodine; D015242:Ofloxacin