Bacteriology and antibiotic susceptibility of chronic dacryocystitis

Abstract

Introduction: Chronic dacryocystitis is an inflammation of lacrimal sac usually diagnosed clinically. It is an important cause of ocular morbidity. It is a constant threat of infection to orbital soft tissues and cornea as it acts as a reservoir of infection. Objectives: · To identify the current spectrum of bacterial isolates from lacrimal sac mucosa in cases of chronic dacryocystitis and to · Determine the antibiotic susceptibility pattern of the isolates. Design: Hospital based cross sectional study. Materials and Methods: The study was conducted at a tertiary care teaching hospital in North Karnataka. Bacteriological profile of chronic dacryocystitis was evaluated from April 2014 to October 2016. A total of 108 patients with chronic dacryocystitis were evaluated. Sample were taken directly from the lacrimal sac while making posterior flap of the lacrimal sac during external dacryocystorhinostomy (Ex DCR) and excised sac during dacryocystectomy (DCT) for chronic dacryocystitis was directly inoculated on culture plates for identification and sensitivity of the pathogens. Results: All the patients were in age group of 30 and above. Male to female ratio was 1:2. Out of 108 patients, 42.6% were culture positive. The most common isolates were Coagulase negative staphylococci (67.39%) followed by Staphylococcus aureus (17.39%). Conclusion: Majority of the chronic dacryocystitis cases were caused by Coagulase negative staphylococci followed by Staphy­lococcus aureus. Isolation of Methicillin Resistant Coagulase Negative Staphylococci was noteworthy and may be indicative of a trend in lacrimal sac infections in this area. These i¬ndings will help us to revise the pre and post-operative antibiotic usage protocols at our institute. Keywords: Chronic dacryocystitis, Coagulase negative Staphylococci (CONS), DCR, DCT, Methicillin resistant coagulase negative staphylococci (MRCONS), Nasolacrimal duct