Lacrimal sac infections and microbial analysis

Abstract

Lacrimal sac infection is one of the common pathologies in a routine ophthalmic practice. Dacryocystitis often present as epiphora with or without discharge. Regurgitation of mucopurulent discharge from punctum is a specific indicator of sac infection. In this article, we have reviewed the literature on the microbial spectrum in lacrimal duct obstruction with sac infection. The common microbial organism and the antibiotic sensitivity status of the same have also been reviewed. More than 90% culture positivity is noted in all the studies as noted in the literature. Gram-positive organism is the commonest source of infection. Staphylococcal species, namely, Staphylococcus aureus have been noted to be the most common among the Gram-positive organisms. The other Gram-positive organisms include Streptococcus pneumonia and Staphylococcus epidermidis. The Gram-negative organisms predominantly seen are Pseudomonas aeruginosa, Hemophilus influenza, and Klebsiella. Very rarely anaerobic organism such as Propionibacterium, fungi like Candida, other Gram-negative microbes such as Enterobacter, and occasionally, Mycobacterium are also cultured. Gram-positive organisms are sensitive to Vancomycin, Ofloxacin, Gatifloxacin, and Chloramphenicol. Gram-negative organisms showed sensitivity to Tobramycin. Resistant to topical quinolones has also been reported in some studies. The overall antibiotic sensitivity has been good and encouraging in the management of lacrimal sac infections.