povidone-iodine and Eye-Infections--Fungal

Comparative evaluation of polyvinylpyrrolidone (PVP)-iodine versus topical broad-spectrum antibiotics for disinfecting the eye and surrounding area to prevent postoperative complications was carried out on 100 patients. PVP-iodine proved superior antiseptic for pre-operative preparation of eyes before cataract surgery. It was cheaper, caused minimal side-effects, reduced bacterial counts to a great extent and eliminated fungi completely.

Topics: Anti-Infective Agents, Local; Antibiotic Prophylaxis; Cataract Extraction; Eye Infections, Bacterial; Eye Infections, Fungal; Humans; Ophthalmic Solutions; Postoperative Complications; Povidone-Iodine

We report a unique case of fungal keratitis, caused by the Cladosporium species, which is found to be resistant to multiple drugs, including voriconazole. Cladosporium belongs to the dematiaceous group of fungus, which is present ubiquitous in air, water, food etc. There are only few case reports available about Cladosporium keratitis which shows the successful management with voriconaozle. But in our case, the Cladosporium species was found to be resistant to multiple drugs, including voriconazole, and was successfully managed by topical povidone iodine (PVI) 5%.

Topics: Antifungal Agents; Cladosporium; Corneal Ulcer; Eye Infections, Fungal; Humans; Keratitis; Povidone-Iodine; Voriconazole

This study aimed to investigate the efficacy of intravitreal povidone-iodine (PI) administration for the treatment of Candida albicans endophthalmitis. Forty New Zealand white rabbits were divided into four groups (n = 10 per group). After the induction of endophthalmitis using Candida albicans, groups A, B, and C received single intravitreal injections of 0.035 mg voriconazole, 0.3 mg PI, and their combination, respectively. Rabbits that were administered sham injections were in group D as controls. Fundus photography, vitreous culture, electroretinography (ERG), and histologic examinations of the retina were conducted on day 7. The anterior chamber flare (grade 0 to 4), severity of iritis (grade 0 to 4), and vitreous opacity (grade 0 to 3) were scored. Candida albicans was cultured in the vitreous sample. On day 7, the vitreous opacities were found in all groups. Compared to that in group D, groups A, B, and C showed a lower score for flare (p < 0.001) and iritis (p < 0.001) and less fungal growth in the vitreous culture (n = 2, 1, 1, and 10 in groups A, B, C, and D, respectively; p < 0.001). Furthermore, ERG and histologic findings demonstrated less affected a- and b-waves and damaged retinal tissues in groups A, B, and C. However, these findings were not different among groups A, B, and C. PI significantly improved Candida albicans endophthalmitis, and the effect was comparable that of the voriconazole, although some vitreous opacities remained. No synergistic effect of the combination of PI and voriconazole was observed. Intravitreal PI may be useful to treat Candida albicans endophthalmitis.

Topics: Animals; Anti-Infective Agents, Local; Candida albicans; Candidiasis; Disease Models, Animal; Endophthalmitis; Eye Infections, Fungal; Female; Intravitreal Injections; Povidone-Iodine; Rabbits

To evaluate the effect on donor rim cultures and postoperative infections of doubling the povidone-iodine exposure time during corneal tissue recovery before its use in keratoplasty.. Consecutive donor cornea recoveries were evaluated for positive donor corneal rim cultures and postoperative infections before and after a protocol change of doubling the exposure time of povidone-iodine during donor preparation.. In 631 consecutive cornea donor recoveries, 18 (2.9%) had positive fungal rim cultures and 41 (6.5%) had positive bacterial rim cultures. Three (0.48%) developed postoperative fungal infections, and no bacterial infections occurred. After doubling the povidone-iodine exposure time during the recovery process, 725 consecutive corneas were reviewed. Four (0.6%) had positive fungal rim cultures, and 29 (4.0%) had positive bacterial rim cultures. No postoperative fungal or bacterial infections occurred. No noticeable increase in epithelial toxicity developed between the 2 groups.. Increasing the povidone-iodine exposure time during the donor cornea recovery process decreased the rate of positive donor corneal rim fungal cultures (P = 0.001), positive donor corneal rim bacterial cultures (P = 0.04), and postoperative fungal infections (P = 0.06).

Topics: Anti-Infective Agents, Local; Corneal Transplantation; Eye Infections, Bacterial; Eye Infections, Fungal; Humans; Postoperative Complications; Povidone-Iodine; Tissue and Organ Harvesting

This study investigated the efficacy of a novel povidone-iodine based disinfection solution for rigid gas permeable (RGP) lenses compared to three other currently available multipurpose and hydrogen peroxide solutions. Bactericidal and fungicidal activities were assessed using ISO 14729 reference methods, whilst amoebicidal properties were evaluated using an automated viability counter. All solutions were also assessed for long term storage stability over a 3-month period. The FDA guidelines were adequately achieved by all solutions tested and 3-month storage did not affect their activity against bacterial and fungal agents. Activity against Acanthamoeba castellani trophozoites reached 1-log reduction for the povidone-iodine solution and approached this level for the remaining solutions. Activity against cysts was somewhat reduced and ranged from 78 to 86% reduction in viability. A povidone-iodine based solution, which may offer advantages as resistance to this agent has not been demonstrated and it lacks toxicity, provided equivalent antimicrobial activity to other RGP solutions.

Topics: Anti-Infective Agents, Local; Bacteria; Contact Lens Solutions; Disinfection; Eye Infections, Bacterial; Eye Infections, Fungal; Fungi; Humans; Povidone-Iodine

The aim of the study was to determine the antimycotic effect of selected substances, povidone iodine at various concentrations and fluconazole, on the growth and development of Colletotrichum spp., which is one of the ocular pathogens.. The materials used for the study consisted of 1-spore cultures of 4 fungal species of the genus Colletotrichum: C. dematium, C. gloeosporioides, C. acutatum, and C. coccodes. The method of poisoning culture media and the method of stippling the substance onto fungal colonies were used in the study. Different concentrations of fluconazole (1%) and povidone iodine (1%, 2% and 5%) were evaluated.. The growth of the studied fungal species was inhibited in 100% on the medium containing povidone iodine at the concentration of 1%, 2%, and 5%. After 24 h from the application of povidone iodine, a local disappearance of aerial mycelium was observed. In the case of C. coccodes, the colonies were not damaged. After 24 h from the application of fluconazole on C. dematium, C. gloeosporioides and C. acutatum colonies, slight disappearance of aerial mycelium was observed at these points. Despite dispensing the substance during the next few days, the inhibitory effect did not increase. After the application fluconazole on the C. coccodes colonies, the inhibitory effect of the preparation was not observed.. The method of stippling of a preparation onto fungal colonies is a quick and reliable method to test many pharmacological substances. One percent, 2%, and 5% povidone iodine in culture medium is fungicidal for Colletotrichum spp. One percent fluconazole in culture medium is fungistatic for Colletotrichum spp. C. coccodes reveals the highest degree of insusceptibility to antimycotic treatment.

Topics: Anti-Infective Agents, Local; Antifungal Agents; Colletotrichum; Eye Diseases; Eye Infections, Fungal; Fluconazole; Humans; Povidone-Iodine

In developing countries where systemic antifungal are often unavailable, treatment of filamentous fungi infection as Fusarium is sometimes very difficult to treat. We report the case of a keratomycosis due to Fusarium oxysporum treated by povidone iodine eye drops and oral fluconazole. The diagnosis of abscess in the cornea was retained after ophthalmological examination for a 28-year-old man with no previous ophthalmological disease, addressed to the Ophthalmological clinic at the University Hospital Le Dantec in Dakar for a left painful red eye with decreased visual acuity lasting for 15 days. The patient did not receive any foreign body into the eye. Samples by corneal scraping were made for microbiological analysis and the patient was hospitalized and treated with a reinforced eye drops based treatment (ceftriaxone+gentamicin). The mycological diagnosis revealed the presence of a mold: F. oxysporum, which motivated the replacement of the initial treatment by eye drops containing iodized povidone solution at 1% because of the amphotericin B unavailability. Due to the threat of visual loss, oral fluconazole was added to the local treatment with eye drops povidone iodine. The outcome was favorable with a healing abscess and visual acuity amounted to 1/200th. Furthermore, we noted sequels such as pannus and pillowcase. The vulgarization of efficient topical antifungal in developing countries would be necessary to optimize fungal infection treatment.

Topics: Administration, Oral; Adult; Corneal Ulcer; Drug Therapy, Combination; Eye Infections, Fungal; Fluconazole; Fusarium; Humans; Male; Ophthalmic Solutions; Povidone-Iodine

We report the successful management of a rare case of bilateral post-laser in situ keratomileusis (LASIK) Fusarium oxysporum keratitis and propose a therapeutic strategy. A 19-year-old white man with no systemic diseases was referred to our emergency service 3 days after microkeratome-assisted myopic bilateral LASIK correction. He complained of blurred-vision, photophobia, and ocular pain. Clinical findings (satellite lesions, hypopyon) suggested fungal keratitis. Flaps were immediately lifted and rinsed with povidone-iodine 10%, and intensive topical and systemic and combined antifungal and antibacterial treatment was introduced. Topical cortisone drops were administered after 3 days. Despite initial deterioration of the clinical picture, all symptoms resolved quickly. Polymerase chain reaction indicated F oxysporum. Relapse occurred in the left eye, which was successfully managed. The final uncorrected distance visual acuity was 20/20 in both eyes. Fusarium oxysporum post-LASIK keratitis may occur in the early phase. Prompt diagnosis, interface irrigation with povidone-iodine solution, and intensive long-term treatment contribute to a favorable outcome.. No author has a financial or proprietary interest in any material or method mentioned.

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Corneal Ulcer; DNA, Fungal; Drug Therapy, Combination; Eye Infections, Fungal; Fusariosis; Fusarium; Glucocorticoids; Humans; Keratomileusis, Laser In Situ; Lasers, Excimer; Male; Myopia; Polymerase Chain Reaction; Postoperative Complications; Povidone-Iodine; Prednisolone; Visual Acuity; Young Adult

Fungal infection is rarely investigated in keratitis. The authors report five cases of fungal keratitis observed at the le Dantec University Teaching Hospital of Dakar, Senegal, involving two males and three females. Diagnosis was made by examination of smears and cultures of corneal scrapings revealing Candida albicans isolated in four patients and Acremonium strictium in another after 2 or 12 weeks of treatment with antibiotics, antivirals, or steroids. Povidone iodine 2.3% concentrated eye drop was used alone or with an azole for 4 a mean of weeks. All patients presented corneal scars. Fungal keratitis must be considered in presence of torpid corneal ulcer and corneal scraping must be systematically done. Topical povidone iodine alone or associated with azole may be an alternative fungal keratitis treatment in intertropical areas.

Topics: Administration, Topical; Adult; Aged; Anti-Infective Agents, Local; Eye Infections, Fungal; Female; Humans; Keratitis; Male; Middle Aged; Povidone-Iodine

To determine the efficacy of 0.02% polyhexamethylene biguanide and 1% povidone iodine in experimental keratitis.. Aspergillus fumigatus keratitis was induced by corneal intrastromal injection of spores in 24 healthy rabbits that were randomly divided into four groups of six rabbits each. Drugs used were 5% natamycin (standard antifungal), 0.02% polyhexamethylene biguanide (PHMB) (test drug), 1% povidone iodine (test drug), and 0.5% hydroxypropylmethyl cellulose (HPMC) (control).. The average healing times of the ulcer were 21.5 +/- 3.08 days with 5% natamycin, 27.8 +/- 2.28 days with 0.02% PHMB, 36.4 +/- 2.57 days with 1% povidone iodine, and 38.2 +/- 4.74 days with 0.5% HPMC. While no corneal perforations occurred with natamycin treatment, one perforation was noted with PHMB, three perforations were noted with povidone iodine, and five perforations were noted with controls.. Polyhexamethylene biguanide (0.02%) is a moderately effective drug for experimental Aspergillus keratitis, but 1% povidone iodine is not effective.

Topics: Animals; Anti-Infective Agents, Local; Aspergillosis; Aspergillus fumigatus; Biguanides; Corneal Stroma; Disinfectants; Drug Evaluation; Eye Infections, Fungal; Keratitis; Natamycin; Ophthalmic Solutions; Povidone-Iodine; Prospective Studies; Rabbits; Random Allocation

Povidone-iodine (PVP -I) is applied for microbial decontamination of human eyes donated for transplantation. Concentrations and immersion times vary greatly. The effectiveness and toxicity of PVP-I were assessed for different decontamination protocols.. Human donor eyes and corneas were immersed in different concentrations (5-100 mg/ml) of PVP-I for different times (2-30 minutes). The penetration of iodine into the corneal tissue was assessed by x ray microanalysis. Microbial contamination was determined by taking cultures of the limbal areas and storage solutions and by incubation of the corneoscleral buttons in antibiotic-free culture medium. Cytotoxicity of PVP-I for corneal fibroblasts in culture was assessed using the MTT assay.. Depending on concentration and immersion time iodine was found to penetrate into the epithelium, Bowman's layer, and stroma in amounts equivalent to 2-40 mg/ml PVP-I. The MTT assay demonstrated that 2.5 mg/ml PVP-I caused total damage to fibroblasts in vitro. Rinsing eyes with tap water and subsequent immersion in PVP-I reduced the rate of contamination from 82 out of 106 to 69 out of 106 and 37 out of 106, respectively. Antibiotics in the storage medium further reduced contamination from about 40% to 3%. Microbial contamination was not reduced by increasing the concentration and immersion times beyond 5 mg/ml PVP-I for 2 minutes.. Immersion of human donor eyes in 5 mg/ml PVP-I solution for 2 minutes significantly reduces microbial contamination of donor corneas without relevant penetration of iodine into the corneal layers. Higher PVP-I concentrations and longer immersion times do not further reduce contamination, whereas the amount of iodine penetrating the corneal layers is elevated above the level cytotoxic for corneal fibroblasts. In view of this, concentrations above 5 mg/ml of PVP-I and immersion periods over 2 minutes are not recommended for reduction of the contamination rate of donor eyes.

Topics: Anti-Infective Agents, Local; Calibration; Corneal Transplantation; Dose-Response Relationship, Drug; Eye; Eye Infections, Bacterial; Eye Infections, Fungal; Fibroblasts; Humans; Microscopy, Electron, Scanning; Povidone-Iodine; Toxicity Tests

The medical records of 39 horses treated for ulcerative keratomycosis over a 10 year period were reviewed. Records were evaluated to determine the medical and/or surgical treatment protocol, visual outcome, globe survival and whether the outcome was influenced by the fungal species isolated. Stromal abscesses and iris prolapses caused by fungi were not included. Twenty of the horses underwent medical treatment only, and 19 horses had combined medical and surgical treatment. Most horses had been treated with topical antibiotics (n = 32) and atropine sulphate (n = 23) prior to referral; topical antifungals had been employed less frequently (n = 14). Fungi were identified by cytology (n = 31), culture (n = 33) and/or surgical histopathology (n = 6). Aspergillus (n = 13) and Fusarium (n = 10) were the most commonly isolated fungi. Miconazole (n = 35) was the most common topical antifungal medication utilised. Median duration of treatment was 48 days (range 31-192 days). Associated bacterial infection (n = 13) was frequently encountered. Visual outcome was favourable in 36/39 (92.3%) eyes. All eyes (20/20) retained vision following medical management only, and 16/19 (84%) retained vision following combined medical and surgical therapy. All medically treated horses (20/20), and 17/19 (89%) of those treated medically and surgically retained their globes. Overall ocular survival was favourable in 37/39 (94.9 %) eyes. Aggressive therapy can result in successful results for equine ulcerative keratomycosis.

Topics: Animals; Anti-Infective Agents, Local; Antifungal Agents; Aspergillus; Corneal Stroma; Corneal Ulcer; Eye Infections, Fungal; Female; Fusarium; Histocytochemistry; Horse Diseases; Horses; Male; Miconazole; Povidone-Iodine; Retrospective Studies; Silver Sulfadiazine; Treatment Outcome; Vision, Ocular

Between May 1983 and December 1989, 2,921 donor eyes received by the Minnesota Lions Eye Bank underwent a decontamination protocol using 10% Betadine (1% povidone-iodine) solution. Positive pretreatment limbal cultures were obtained on 52.1% of donor eyes. Posttreatment limbal cultures demonstrated a 76.1% reduction in microbial growth, including an 85.7% reduction in Candida species. Streptococcus species were reduced by 76.7% and coagulase-negative Staphylococcus were reduced by 76.1%. In addition, of 250 donor rims obtained at the time of surgery, two had coagulase-negative. Staphylococcus present that were also present after the decontamination procedure. In no cases did endophthalmitis occur during this study. This study demonstrates that this protocol using 10% Betadine solution is extremely effective in decontaminating donor globes of aerobic bacteria and fungi. However, gentamicin-resistant organisms survived this protocol, emphasizing the need to develop storage media containing a broader-spectrum antibiotic agent then gentamicin.

Topics: Bacteria; Corneal Transplantation; Eye; Eye Infections, Bacterial; Eye Infections, Fungal; Fungi; Humans; Microbiological Techniques; Povidone-Iodine