Dacryocystitis – A Study of its Microbiological Spectrum at a Tertiary Eye Care Hospital in Hyderabad, India

Abstract

Abstract Objectives: Dacryocystitis is the infection of the lacrimal sac due to obstruction within the nasolacrimal duct leading to inflammation resulting in several symptoms such as pain, redness, and swelling in the lacrimal sac area, persistent watering from the eye (epiphora), and if untreated may lead to many devastating complications. This study was undertaken to evaluate and understand the microbiological profile of dacryocystitis and its antibiotic susceptibility pattern for the choice of better and effective treatment, among the patients attending a tertiary eye care hospital. Materials and Methods: This was a study done from January 2022 to December 2022 wherein a total of 98 samples were collected from all those cases fulfilling the inclusion criteria and diagnosed as acute and chronic dacryocystitis by the ophthalmologists and processed as per the Clinical and Laboratory Standards Institute guidelines for the bacterial and fungal culture and their antibiotic susceptibility pattern in the microbiological laboratory. Results: Among the 98 patients diagnosed with dacryocystitis, the incidence of chronic cases, 76 (77.55%), was higher when compared to acute cases, 22 (22.45%), with females, 74 (75.51%), being dominant. Most isolated bacteria were the Gram-positive cocci, followed by Pseudomonas among the Gram-negative organisms, while Aspergillus, Candida, and Fusarium were the isolated fungi. Most of the Gram-positive cocci were susceptible to fourth-generation fluoroquinolone like gatifloxacin and aminoglycoside antibiotics like amikacin, and the Gram-negative organisms were highly susceptible to fluoroquinolones, aminoglycosides, and cephalosporins. Conclusions: Dacryocystitis with its destructive complications such as lacrimal sac abscesses, lacrimal fistulas, meningitis, cavernous sinus thrombosis, vision loss, and sometimes death have to be dealt with seriously by the ophthalmologist. There must be prompt referral to the microbiological laboratory for culture and sensitivity. This aids in understanding the microbial organisms responsible in a particular geographical area and in selecting the appropriate antibiotic and also aids in prompt improvement of the patient’s condition and reduces the risk of secondary ocular infections and other complications.