Efficacy of Picloxidine and Staphylococcal Bacteriophage in Preoperative Eradication of Staphylococcus Epidermidis

In view of the current trend — growth of antibiotic resistance, the search for possible alternative methods of preoperative prophylaxis is relevant. The purpose : to assess the impact of different methods of preoperative eradication of Staphylococcus epidermidis (the use of specific bacteriophage and picloxidine in combination with eyelid massage) on conjunctival and aqueous moisture contamination in the course of planned phacoemulsification. Patients and Methods . 44 patients (48 eyes) were examined. Patients in group I underwent eradication with staphylococcal bacteriophage in combination with eyelid massage, in group II — with picloxidine according to the similar technique, group III was control group. Microbiological material was sampled from the conjunctival cavity before the application of the said methods and after blepharostat placement. Anterior chamber fluid (ACF) was examined at the end of the operation. Microorganisms were identified by MALDI-TOF method, sensitivity was determined by drip method. Results . The percentage of S. epidermidis contamination of conjunctiva after blepharostat placement was 25.0 %, 68.8 % and 87.5 % in groups I, II, III, respectively, in the ACF it was found in 0.0 %, 12.5 % and 37.5 % in groups I, II, III, respectively. Conclusion . Preoperative measures for S. epidermidis eradication with staphylococcal bacteriophage in combination with eyelid massage are significantly more effective than the similar technique with picloxidine and provide a significant reduction of conjunctival sac contamination by 75 %, and also absence of S. epidermidis in the ACF by the time of phacoemulsification completion.