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Canadian Journal of Anesthesia

, Volume 51, Issue 9, pp 932–936 | Cite as

Gargling with povidone-iodine reduces the transport of bacteria during oral intubation

  • Junichi Ogata
  • Kouichiro Minami
  • Hiroshi Miyamoto
  • Takafumi Horishita
  • Midori Ogawa
  • Takeyoshi Sata
  • Hatsumi Taniguchi
Cardiothoracic Anesthesia, Respiration and Airway

Abstract

Purpose

Nosocomial pneumonia remains a common complication in patients undergoing endotracheal intubation. This study examined the transport of bacteria into the trachea during endotracheal intubation, and evaluated the effects of gargling with povidone-iodine on bacterial contamination of the tip of the intubation tube.

Methods

In the gargling group, patients gargled with 25 mL of povidone-iodine (2.5 mg· mL−1). In the control group, patients gargled with 25 mL of tap water. Before tracheal intubation, microorganisms were obtained from the posterior wall of the patient’s pharynx using sterile cotton swabs. After anesthesia, all patients were extubated and bacteria contaminating the tip of the tracheal tube were sampled and cultured.

Results

Before orotracheal intubation, all 19 patients who gargled with tap water (control group) had bacterial colonization on the posterior walls of the pharynx. This group included five patients who had methicillin-resistant staphylococcus aureus (MRSA) in their nasal cavity preoperatively and MRSA was also detected in the pharynx of four patients. Bacterial colonization was observed in all 19 patients who gargled with povidone-iodine (gargling group) and four patients carried MRSA in their nasal cavity, although no MRSA was detected in the pharynx. In the control group, all the patients had bacterial colonization at the tip of the tube after extubation. Additionally, MRSA was detected in two of the four patients. In the gargling group, povidone-iodine eradicated general bacteria and MRSA colonies in the pharynx before intubation and at the tip of the tube after extubation.

Conclusion

Gargling with povidone-iodine before oral intubation reduces the transport of bacteria into the trachea.

Keywords

Endotracheal Intubation Tracheal Tube Bacterial Colonization Povidone Selective Digestive Decontamination 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Le gargarisme avec un mélange de povidone-iode réduit le transport bactérien pendant l’intubation orale

Résumé

Objectif

La pneumonie nosocomiale est une complication encore fréquente à la suite d’une intubation endotrachéale. Nous avons vérifié le transport des bactéries à l’intérieur de la trachée pendant l’intubation endotrachéale et évaluons les effets du gargarisme avec povidone iodé sur la contamination bactérienne de la pointe du tube d’intubation.

Méthode

Les patients du groupe de gargarisme ont utilisé 25 mL de povidone iodé (2,5 mg· mL−1). Les patients témoins se sont gargarisés avec 25 mL d’eau du robinet. Avant l’intubation trachéale, les microorganismes ont été prélevés sur la paroi postérieure du pharynx au moyen de coton-tiges stériles. Après l’anesthésie, tous les patients ont été extubés et les bactéries de la pointe du tube trachéal ont été prélevées et mises en culture.

Résultats

Avant l’intubation orotrachéale, on a détecté des bactéries sur les parois postérieures du pharynx chez les 19 patients témoins. Ce groupe comprenait cinq patients avec staphylocoque aureus résistant à la méthicilline (SARM) dans la cavité nasale avant l’opération. Le SARM a aussi été détecté dans le pharynx de quatre patients. Il y avait une colonisation bactérienne chez les 19 patients qui ont utilisé le mélange povidone iodé. On a retrouvé le SARM dans la cavité nasale de quatre patients, mais non dans le pharynx. Tous les patients témoins présentaient une colonisation bactérienne à la pointe du tube après l’extubation. De plus, le SARM a été détecté chez deux des quatre patients. Par contre, la povidone iodé a éliminé les bactéries en général et les colonies de SARM dans le pharynx avant l’intubation et à la pointe du tube après l’extubation.

Conclusion

Le gargarisme avec povidone iodé avant l’intubation orale réduit le transport bactérien dans la trachée.

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Copyright information

© Canadian Anesthesiologists 2004

Authors and Affiliations

  • Junichi Ogata
    • 1
  • Kouichiro Minami
    • 1
  • Hiroshi Miyamoto
    • 2
  • Takafumi Horishita
    • 1
  • Midori Ogawa
    • 2
  • Takeyoshi Sata
    • 1
  • Hatsumi Taniguchi
    • 2
  1. 1.Department of AnesthesiologyUniversity of Occupational and Environmental Health School of MedicineFukuokaJapan
  2. 2.Department of MicrobiologyUniversity of Occupational and Environmental Health School of MedicineFukuokaJapan

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