title: Bacterial dispersal associated with speech in the setting of intravitreous injections.
abstract: OBJECTIVE
  To investigate the amount of bacterial dispersal associated with speech in a simulated intravitreous injection.
  
  
  METHODS
  Fifteen volunteers were recruited. Each volunteer was positioned over an open blood agar plate and did the following: read a 5-minute script with a face mask, read a 5-minute script without a face mask, read a 5-minute script with the face turned away from the plate without a face mask, and stood in silence for 5 minutes. Each volunteer then read a 5-minute script while reclined in a standard ophthalmic examination chair with an open blood agar plate secured to the forehead to simulate bacterial dispersal associated with a talking patient. Total numbers of colony-forming bacteria per plate were counted, and the bacteria were identified.
  
  
  RESULTS
  Significantly less bacterial growth occurred in the face mask and silence conditions compared with the no face mask condition (both P < .001). Bacterial growth was significantly greater in the reclined condition compared with the room control (P = .02). Oral streptococcal species represented 66.7% to 82.6% of bacterial colonies in the no face mask, face turned, and reclined conditions.
  
  
  CONCLUSIONS
  During simulated intravitreous injection, wearing a face mask or remaining silent significantly decreases culture plate contamination from talking. Talking from above and talking in the reclined position were associated with a significant increase in culture plate contamination. Physicians performing intravitreous injections should be aware of these patterns of bacterial contamination, should consider either wearing a face mask or minimizing speech, and should encourage patients to minimize speech during the procedure.
authors.affiliation: Jules Stein Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095, USA.
authors.forename: Joanne C
authors.initials: JC
authors.lastname: Wen
authors.forename: Colin A
authors.initials: CA
authors.lastname: McCannel
authors.forename: A Brian
authors.initials: AB
authors.lastname: Mochon
authors.forename: Omai B
authors.initials: OB
authors.lastname: Garner
mesh_terms: D001419:Bacteria / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000635:transmission*; D015169:Colony Count, Microbial; D009877:Endophthalmitis / Q000382:microbiology; D004866:Equipment Contamination / Q000517:prevention & control; D015818:Eye Infections, Bacterial / Q000517:prevention & control*; D006801:Humans; D058449:Intravitreal Injections; D008397:Masks / Q000382:microbiology*; D009055:Mouth / Q000382:microbiology*; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D012137:Respiratory System / Q000382:microbiology; D013060:Speech
chemical_list: D004364:Pharmaceutical Preparations