Abstract
Purpose: :
To evaluate and compare the bacterial anti-adhesive effect of cefuroxime and moxifloxacin on the primary-attachment phase of Staphylococcus epidermidis to hydrophobic acrylic intraocular lenses (IOLs).
Methods: :
Forty single-piece Acrysof IOLs (SA30AT, Alcon Surgical) were used throughout the study. IOLs were divided into 5 groups. Two groups were soaked 15 minutes in an antibiotic solution (Mox: moxifloxacin 0.5mg/0.1ml or Cef: cefuroxime 1mg/0.1ml), before incubation for 1 hour in a S epidermidis bacterial suspension which concentration was adjusted to 108 CFU/ml (N890074, Staphylococci National reference Centre, Lyon, France), (t1). Two other groups were incubated in a similar S epidermidis suspension for 15 minutes before adding cefuroxime or Moxifloxacin (t2). Incubation for these groups lasted 1 hour. The last group consisted in a control group with IOLs incubated 1 hour in the S epidermidis bacterial suspension. After incubation, IOLs were removed from the vial test and rinsed in a sterile phosphate-buffered solution before being sonicated and vortexed to remove all the adhering bacteria. The resultant suspension was diluted and spread over a nutritive agar plate. Colonies were counted after 24-hour incubation. Comparison among groups was performed using the Wald parametric statistical test. A p-value < 0.05 was considered statistically significant.
Results: :
Mean numbers of CFU per IOL was Cef-t1: 184 x103[SE: 5,24 ; SD: 28,21], Cef-t2: 117 x103[SE: 5,74 ; SD: 30,37], Mox-t1: 1,27x103[SE: 0,12 ; SD: 0,61], Mox-t2: 25 x103[SE:1,98 ; SD: 9,72] and Ctrl : 361 x103[SE: 26,9 ; SD: 107,6]. The number of adhering bacteria did not vary whether cefuroxime was added before or after IOLs incubation in the bacterial suspension (p = 0.132). Moxifloxacin was more effective in reducing the number of adhering bacteria when used before IOLs incubation (p < 0.001). Overall for t1 and t2, moxifloxacin was more effective than cefuroxime (p < 0,001).
Conclusions: :
The use of moxifloxacin and cefuroxime significantly reduced S.epidermidis adherence on hydrophobic acrylic IOLs. The anti-adhesive effect was superior with moxifloxacine. Further studies are needed to confirm these results on IOLs made of other biomaterials.
Keywords: endophthalmitis • intraocular lens • Staphylococcus