Comparative efficacy of two methods of skin preparation of the perineal and genital skin of male urological patients

To compare the efficacy of two methods of skin antiseptic preparations of the genitalia and perineum in male urological patients. Prospective study. Mubarak Hospital, Kuwait. Adult male patients of two study groups numbering 114 [group-1] and 117 [group-2] admitted for cystoscopic procedures. The perineum and genitalia of patients in both groups were prepared by applying chlorhexidine-cetrimide mixture [CCM] and CCM plus povidone-iodine solution respectively. Swab specimens were obtained from the perineum and genitalia, before cleaning and disinfection [specimen A], after disinfection and draping [specimen B] and after the completion of the operative procedure [specimen C]. Specimens were cultured on appropriate media and representative colonies identified by standard methods. In groups 1 and 2, the A specimen yielded bacterial growth in 35.1 and 63% of patients, respectively. The commonest isolates in both groups were Gram-positive bacteria [89.2%] while Gram-negative bacteria accounted for only 10.8%. The B and C specimens in group-1 yielded positive bacterial culture in 7.1 and 11.4% patients respectively. In group-2, specimens B and C yielded bacterial growth in 5.1 and 2.6% patients respectively. In both groups, there was a significant reduction of patients with culture-positive B specimens after skin disinfection [p < 0.001]. The isolation rate of bacteria in specimen C in group-2 was significantlylower than group-1 patients [p < 0.001]. The addition of povidone-iodine to the CCM based regimen of perineal skin antiseptic preparation is associated with longer and more effective skin disinfection in male urological patients