Microbiological profile and antibiotic susceptibility pattern of chronic dacryocystitis at a tertiary eye care centre in Western India

Abstract

: Chronic dacryocystitis is a low-grade infection & inflammation of the lacrimal sac. If neglected the infection may extend to surrounding orbit, brain and paranasal sinuses leading to sight and/or life-threatening complications. Thus appropriate, effective and timely antibiotic treatment/ prophylaxis is desirable. The present study was aimed to document the current microbiological profile and antibiotic susceptibility in adult patients of chronic dacryocystitis seen at our tertiary eye care centre in western India.The study was a cross-sectional, prospective, observational study. The study included 60 adult patients of chronic dacryocystitis. In every case two samples from the lacrimal sac collected via the regurgitation technique or by lacrimal passage syringing were sent for microbiological evaluation. Gram staining was used for identification of bacterial pathogen. KOH mount was used for identification of fungi. The second swab was used for performing culture -sensitivity. The Clinical and Laboratory Standard Institute Guidelines were used to know the antimicrobial sensitivity. Kirby-Bauer disk diffusion method was used for this purpose. The statistical analysis was done using descriptive statistics as mean, standard deviation, median and percentages. Microsoft excel worksheet was used. 60 samples were taken. 53/60 (88.3%) samples showed microbial isolates after 24-48 hours of incubation. 78.3% were gram positive organisms and 10% were gram negative organisms. The most common gram-positive organism was (68.3%) and the most common gram-negative organism was (8.3%). Amongst the antibiotics the most sensitive antibiotic was Ampicillin + Sulbactam (92.5%) and the most resistant antibiotic was Ciprofloxacin (3.8%). The antibiotic most sensitive to gram positive organisms was Ampicillin and Sulbactam, Cephalexin, Linezolid, Cloxacillin and Vancomycin. The antibiotic most sensitive to gram negative organisms was Gentamicin, Amikacin, Gatifloxacin, Ceftazidime, Meropenem and Polymixin -B. The current microbiological profile and antibiotic susceptibility of the microorganisms responsible for chronic dacryocystitis is an invaluable tool in the treatment of chronic dacryocystitis with the most appropriate and effective antibiotic.