Bacterial contamination of needles used for intravitreal injections: a prospective, multicenter study

Ocul Immunol Inflamm. 2011 Feb;19(1):32-8. doi: 10.3109/09273948.2010.520405. Epub 2010 Oct 31.

Abstract

Purpose: To determine the incidence of bacterial contamination of needles used for intravitreal injections.

Methods: Patients undergoing intravitreal injections were enrolled prospectively. No pre-injection antibiotics were administered. Following povidone-iodine irrigation, conjunctival cultures were taken and the injection was performed. The needle was cultured. A dry control needle was exposed to the surgical field and cultured.

Results: No patients developed endophthalmitis. Eighteen injection needles (18%) yielded positive bacterial growth. The most commonly encountered organisms were Propionibacterium acnes (n = 8) and Staphylococcus epidermidis (n = 6). Four control needles showed positive growth, in 2 cases with the same organism as a matching positive used needle. The difference between contamination rates of used and control needles was significant (p = .002, McNemar's test).

Conclusions: Bacterial contaminants are present on a substantial proportion of needles. Since the needle contacts both the ocular surface and the vitreous, it is possible that inoculation of the vitreous cavity occurs in such cases.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Choroidal Neovascularization / drug therapy
  • Cross-Sectional Studies
  • Diabetic Retinopathy / drug therapy
  • Endophthalmitis / microbiology
  • Equipment Contamination*
  • Eye Infections, Bacterial / epidemiology*
  • Eye Infections, Bacterial / microbiology*
  • Female
  • Humans
  • Intravitreal Injections / adverse effects
  • Intravitreal Injections / instrumentation*
  • Macular Degeneration / drug therapy
  • Male
  • Middle Aged
  • Needles / adverse effects
  • Needles / microbiology*
  • Povidone-Iodine / administration & dosage
  • Propionibacterium acnes / isolation & purification
  • Prospective Studies
  • Ranibizumab
  • Staphylococcus epidermidis / isolation & purification
  • Vitreous Body / microbiology

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Povidone-Iodine
  • Ranibizumab