title: Anterior chamber bacterial contamination in cataract surgery.
abstract: BACKGROUND
  The incidence of postoperative endophthalmitis has reduced during last several years to <0.01%; however, its associated complications continue to be devastating. Several sources of infection, including contamination by air, solutions, surgical instruments, intraocular lens, and wound leakage have been identified. The objective of this study was to evaluate the surgical technique, antibiotics, and asepsis that are used to reduce the risk of infection during cataract surgery.
  
  
  METHODS
  This was a transversal prospective study, in which 64 cataract surgeries were evaluated from 32 patients, with 1 month recovery time; and cultures from preoperative and postoperative aspirates were analyzed. Two groups were established based on whether preoperative antibiotics were given or not. The analysis employed descriptive statistics.
  
  
  RESULTS
  Of the 32 patients whose aspirates were obtained, three (9.37%) and 10 (31.25%) yielded positive cultures preoperative and postoperatively respectively. Staphylococcus species was the most common contaminating bacteria. The isolation of Staphylococcus species may indicate its potential as exogenous contaminant at time of wound closure. The cultures obtained from patients using preoperative antibiotics were positive for S. aureus in 10% (n = 2) of cases, and positive in 8.33% (n = 1) of cases not using antibiotics. The mean transoperative time with positive growth was 67 ± 17.8 minutes, and with negative growth was 76.3 ± 25.2 minutes. Two surgical techniques were evaluated: phacoemulsification and extracapsular extraction. The extracapsular technique showed a contamination rate of 33.33% (n = 8) compared to phacoemulsification with a rate of 25% (n = 2) (RR = 1.33).
  
  
  CONCLUSIONS
  Common contaminating microorganisms included the Staphylococcus species, which was isolated from the eyelids and ocular annexes at the time of wound closure. The isolation of microorganisms postoperatively could have been influenced by the surgical technique used, the surgical time, and the use of antibiotics.
authors.affiliation: Ophthalmology Research Chair, Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Av, Morones Prieto No, 3000 Pte, Col, Los Doctores, C,P, 64710 Monterrey, Nuevo León, México. jorge.valdez@itesm.mx.
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Valdez-García
authors.forename: Alejandro
authors.initials: A
authors.lastname: Climent
authors.forename: Eduardo
authors.initials: E
authors.lastname: Chávez-Mondragón
authors.forename: Juan F
authors.initials: JF
authors.lastname: Lozano-Ramírez
mesh_terms: D000867:Anterior Chamber / Q000382:microbiology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D002387:Cataract Extraction / Q000009:adverse effects*; D009877:Endophthalmitis / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D005500:Follow-Up Studies; D006801:Humans; D008800:Mexico / Q000453:epidemiology; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D013210:Staphylococcus / Q000302:isolation & purification*; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents