oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Preoperative preparation of eye with chlorhexidine solution significantly reduces bacterial load prior to 23-gauge vitrectomy in Swedish health care
Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Medical Sciences. Department of Laboratory Medicine.
Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.
Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden.
Show others and affiliations
2018 (English)In: BMC Ophthalmology, ISSN 1471-2415, E-ISSN 1471-2415, Vol. 18, article id 167Article in journal (Refereed) Published
Abstract [en]

Background: Bacteria in the conjunctiva present a potential risk of vitreous cavity infection during 23-gauge pars plana vitrectomy (PPV). Current preoperative procedures used in Sweden include irrigation with chlorhexidine solution (CHX) 0.05% only and no iodine solutions. We evaluated the bacterial diversity and load before and after this single antibacterial measure.

Methods: In a prospective, consecutive cohort we investigated bacterial growth in samples from 40 eyes in 39 consecutive individuals subjected to vitrectomy. A conjunctival specimen was collected from each preoperative patient before and after irrigating of eye with CHX, 0.05% solution. Iodine was not used during any part of the surgery. One drop of chloramphenicol was administered prior to surgery. Samples from vitreous cavity were collected at the beginning and end of vitrectomy. All conjunctival specimens were cultured for different species and quantified using colony forming units (CFU).

Results: There was a significant 82% reduction in the total number of CFUs for all bacteria in all eyes (P < 0.0001), and 90% reduction for coagulase negative staphylococci (CoNS) alone (P = 0.0002). The number of eyes with positive bacterial growth in conjunctival samples decreased from 33 to 18 after irrigation with CHX (P = 0.0023). The most common bacteria prior to surgery were CoNS (70%), Propionibacterium acnes (55%) and Corynebacterium species (36%). No case of post-vitrectomy endophthalmitis was reported during mean follow-up time, which was 4.6 +/- 2.3 (range; 1.5 to 9) months.

Conclusions: Patients undergoing PPV harbored bacteria in conjunctiva capable of causing post-vitrectomy endophthalmitis. Preoperative preparation with CHX significantly reduced the bacterial load in the conjunctival samples subsequently leading to very low inoculation rates in recovered vitreous samples. Thus, CHX used as a single disinfectant agent might be an effective preoperative procedure for eye surgery in Sweden. This is a relatively small study but the results could be a reference for other intraocular surgeries.

Place, publisher, year, edition, pages
BioMed Central, 2018. Vol. 18, article id 167
Keywords [en]
Conjunctival colonization, chlorhexidine solution, Endophthalmitis, Microorganisms, Small-gauge vitrectomy
National Category
Ophthalmology
Identifiers
URN: urn:nbn:se:oru:diva-68241DOI: 10.1186/s12886-018-0844-9ISI: 000438213500001PubMedID: 29996791Scopus ID: 2-s2.0-85049846037OAI: oai:DiVA.org:oru-68241DiVA, id: diva2:1235788
Note

Funding Agencies:

Örebro University Hospital (Sweden)  

Örebro county Council-Research funds  

Available from: 2018-07-27 Created: 2018-07-27 Last updated: 2018-07-27Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records BETA

Norén, TorbjörnBäckman, Anders

Search in DiVA

By author/editor
Norén, TorbjörnBäckman, Anders
By organisation
School of Medical Sciences
In the same journal
BMC Ophthalmology
Ophthalmology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 8 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf