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목적 : Ophthalmic solutions have been found to be contaminated with bacterial pathogens during repeated use. Microorganisms grown from eyedrops flasks have been mainly representatives of the skin flora and the environment, but also, with a low frequency, S. aureus and gram-negative rods. Most of previous researches about contamination rate and culture result were based on eyedrops applied to patient conventionally. However, this study was to investigate the percentage of contamination of multiuse eyedrops applied by medical personnel by intentionally touching the tip of the bottle.
방법 : This was a prospective nonmasked nonrandomized study. Ten different unpreserved and preserved eyedrop formulations in multidose bottles were tested, eye drops for allergy, artificial tears, antibiotics and corticosteroid were included. The tip of the bottle was touched intentionally by experimenter’s hand using finger, palm or back of the hand twice a day. The solutions contained in bottles were cultured by placing just one drop in culture medium under room temperature and low temperature. When culture test proved to be positive, colony forming units were identified by outside institution.
결과 : 13 of 20 eyedrops were contaminated. 1 microorganism was cultivated in 6 cases and species of 4 genera of bacteria were identified. Under refrigerated condition, 3 eye drop bottles were contaminated and under room emperature, 4 eye drop bottles were contaminated. Comparing culture positivity rate by type of eye drops, anti-allergic eyedrops showed 6% and corticosteroid eyedrops showed 17% under both refrigeration and room temperature. Artificial tears under refrigeration, culture positivity rate was 11% and under room temperature the rate was 28%.
결론 : The number of positive samples stored in low temperature are smaller than in room temperature. Among the eyedrop solutions, antibiotics are highly unlikely to be contaminated and showed high safety. It is likely that the low rate of organism recovery is due to the ability of the antibiotic to preserve itself. Also this study underlines the importance of hygienic handling of eye-drops especially in artificial tears without preservatives.
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