COLONIZATION OF THE CONJUNCTIVA WITH PROP IONIBACTERIUM-ACNES BEFORE AND AFTER APPLICATION OF POLYVIDONE IODINE BEFORE INTRAOCULAR SURGERY

Background: Propionibacterium acnes has been described as a causative agent of postoperative endophthalmitis. This gram-positive, immotile, non-spore-forming bacterium is highly pleomorphic and grows under cond itions of low to no oxygen concentration. It is commonly found on the skin at the openings of sebaceous glands and on hairs. A near-symptoml ess postoperative endophthalmitis occurs particularly when Propionibac teria are enclosed in the capsular bag. We investigated to what extent the number of P. acnes in the conjunctival sac can be reduced by preo perative disinfection with polyvidone iodine (1%). Patients and method s: A total of 261 patients with intrabulbar surgery had two conjunctiv al swabs taken: the first immediately prior to preoperative preparatio n in the operating theatre, following in-patient application of antibi otic eye drops (Polymyxin-B-sulfat, Neomycinsulfat and Gramicidin in c ombination); the second swab was taken after disinfection with polyvid one iodine before opening the conjunctiva. Results: Of the 261 swabs, 60 (23%) taken prior to polyvidone iodine application were positive fo r Propionibacterium acnes. Following polyvidone iodine treatment, a fu rther 5 (1.9%) remained culture-positive. After disinfection, 55 (92%) of the 60 positive swabs for Propionibacterium acnes remained culture -negative. Conclusions: We concluded that a significant reduction of P . acnes can be achieved by preoperative application of polyvidone iodi ne (1%) (P < 0.001).