Bacterial Dispersal Associated With Speech in the Setting of Intravitreous Injections

Abstract

To investigate the amount of bacterial dispersal associated with speech in a simulated intravitreous injection. Methods: Fifteen volunteers were recruited. Each volunteer was positioned over an open blood agar plate and did the following: read a 5-minute script with a face mask, read a 5-minute script without a face mask, read a 5-minute script with the face turned away from the plate without a face mask, and stood in silence for 5 minutes. Each volunteer then read a 5-minute script while reclined in a standard ophthalmic examination chair with an open blood agar plate secured to the forehead to simulate bacterial dispersal associated with a talking patient. Total numbers of colony-forming bacteria per plate were counted, and the bacteria were identified. Results: Significantly less bacterial growth occurred in the face mask and silence conditions compared with the no face mask condition (both PϽ.001). Bacterial growth was significantly greater in the reclined condition compared with the room control (P=.02). Oral streptococcal species represented 66.7% to 82.6% of bacterial colonies in the no face mask, face turned, and reclined conditions. Conclusions: During simulated intravitreous injection, wearing a face mask or remaining silent significantly decreases culture plate contamination from talking. Talking from above and talking in the reclined position were associated with a significant increase in culture plate contamination. Physicians performing intravitreous injections should be aware of these patterns of bacterial contamination, should consider either wearing a face mask or minimizing speech, and should encourage patients to minimize speech during the procedure.

Lessons Learnt From 25 Years of Endophthalmitis: Causes, Microbiology and Visual Outcome Trends

“…This is in contrast to earlier reports of streptococcal infection being more common in IVIs [37]. It is possible that this was secondary to increasing respiratory precautions including mask use and limiting conversation, thereby decreasing respiratory pathogen spread [38]. While our results did not demonstrate a trend to reducing over time, it is possible this was due to small numbers overall.…”

Lessons Learnt From 25 Years of Endophthalmitis: Causes, Microbiology and Visual Outcome Trends

“…This is in contrast to earlier reports of streptococcal infection being more common in IVIs [37]. It is possible that this was secondary to increasing respiratory precautions including mask use and limiting conversation, thereby decreasing respiratory pathogen spread [38]. While our results did not demonstrate a trend to reducing over time, it is possible this was due to small numbers overall.…”

Acute Bacterial Tenonitis and Conjunctivitis following Intravitreal Injection

“…Gines et al [ 8 ] have also shown that even with the use of betadine 10% at the injection site prior to IVI, bacteria can persist on the ocular surface. In accordance with the finding made by Wen et al [ 9 ] that wearing a face mask can minimize the risk of bacterial contamination during IVI, the doctor and assistant both wore surgical masks. The patient was instructed not to speak during the procedure but did not wear a surgical mask.…”

Global reported endophthalmitis risk following intravitreal injections of anti-VEGF: a literature review and analysis

“……”

Lessons Learnt From 25 Years of Endophthalmitis: Causes, Microbiology and Visual Outcome Trends

“…This is in contrast to earlier reports of streptococcal infection being more common in IVIs [37]. It is possible that this was secondary to increasing respiratory precautions including mask use and limiting conversation, thereby decreasing respiratory pathogen spread [38]. While our results did not demonstrate a trend to reducing over time, it is possible this was due to small numbers overall.…”

Acute Bacterial Tenonitis and Conjunctivitis following Intravitreal Injection

“…Gines et al [ 8 ] have also shown that even with the use of betadine 10% at the injection site prior to IVI, bacteria can persist on the ocular surface. In accordance with the finding made by Wen et al [ 9 ] that wearing a face mask can minimize the risk of bacterial contamination during IVI, the doctor and assistant both wore surgical masks. The patient was instructed not to speak during the procedure but did not wear a surgical mask.…”

Global reported endophthalmitis risk following intravitreal injections of anti-VEGF: a literature review and analysis

“……”

Lessons Learnt From 25 Years of Endophthalmitis: Causes, Microbiology and Visual Outcome Trends

“…This is in contrast to earlier reports of streptococcal infection being more common in IVIs [37]. It is possible that this was secondary to increasing respiratory precautions including mask use and limiting conversation, thereby decreasing respiratory pathogen spread [38]. While our results did not demonstrate a trend to reducing over time, it is possible this was due to small numbers overall.…”

Acute Bacterial Tenonitis and Conjunctivitis following Intravitreal Injection

“…Gines et al [ 8 ] have also shown that even with the use of betadine 10% at the injection site prior to IVI, bacteria can persist on the ocular surface. In accordance with the finding made by Wen et al [ 9 ] that wearing a face mask can minimize the risk of bacterial contamination during IVI, the doctor and assistant both wore surgical masks. The patient was instructed not to speak during the procedure but did not wear a surgical mask.…”

Global reported endophthalmitis risk following intravitreal injections of anti-VEGF: a literature review and analysis

“……”