title: Reducing oral flora contamination of intravitreal injections with face mask or silence.
abstract: OBJECTIVE
  To provide experimental evidence to support or refute the proposition that the use of surgical face masks and/or avoidance of talking can decrease the dispersion of respiratory flora during an intravitreal injection.
  
  
  METHODS
  Ten surgeons recited a 30-second standardized script with blood agar plates positioned 30 cm below their mouths. The plates were divided into 4 groups, with 10 plates per group. In Group 1, participants did not wear a face mask. In Group 2, participants wore a standard surgical mask. In Group 3, no mask was worn, but plates were pretreated with 5% povidone-iodine. In Group 4, no mask was worn, and participants remained silent for 30 seconds. The plates were then incubated at 37°C for 24 hours, and the number of colony-forming units (CFUs) was determined.
  
  
  RESULTS
  Mean bacterial growth were as follows: Group 1, 8.6 CFUs per subject; Group 2, 1.1 CFUs per subject; Group 3, 0.1 CFUs per subject; and Group 4, 2.4 CFUs per subject. Differences between the groups were statistically significant (P < 0.05), with the exception of Group 2 versus Group 4 (P = 0.115).
  
  
  CONCLUSIONS
  The use of a face mask and avoidance of talking each significantly decreased the dispersion of bacteria. Even without these interventions, plates pretreated with povidone-iodine demonstrated the least bacterial growth.
authors.affiliation: Department of Ophthalmology, California Pacific Medical Center, San Francisco, California 94115, USA.
authors.forename: Rishi R
authors.initials: RR
authors.lastname: Doshi
authors.forename: Theodore
authors.initials: T
authors.lastname: Leng
authors.forename: Anne E
authors.initials: AE
authors.lastname: Fung
mesh_terms: D000891:Anti-Infective Agents, Local; D001419:Bacteria / Q000302:isolation & purification; D015169:Colony Count, Microbial; D009877:Endophthalmitis / Q000382:microbiology / Q000517:prevention & control*; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000517:prevention & control*; D006801:Humans; D058449:Intravitreal Injections / Q000009:adverse effects*; D008397:Masks; D011206:Povidone-Iodine; D012137:Respiratory System / Q000382:microbiology*; D014705:Verbal Behavior
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine