The Microbiological Spectrum and Antibiotic Sensitivity Profile of Extubated Silicone Stents Following Dacryocystorhinostomy

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Purpose: We aim to report the microbiological spectrum of organisms cultured from extubated silicone stents after a dacryocystorhinostomy and their antibiotic sensitivity patterns.Study Design: Prospective interventional study.Methods: 50 silicone stents of 50 consecutive patients who underwent either external or endonasal dacryocystorhinostomy were enrolled for the study. All the stents were retrieved under endoscopic guidance from the nasal cavity at 3 months following surgery. All the tubes were immediately inoculated onto blood agar, chocolate agar, brain-heart infusion broth, Saboraud’s dextrose agar and potato dextrose agar. Data collected and analyzed include demographics, diagnosis, type of dacryocystorhinostomy and the microbiological profile. The culture results, organisms isolated and their antibiotic sensitivity were studied.Results: The mean age of patients at the time of dacyrocystorhinostomy was 34.4 years. Bacterial growth was noted in 88% (44/50) of all the stents cultured, whereas 60% (30/50) grew fungi and 6% (3/50) showed sterile cultures. 48% (24/50) of the stents showed mixed bacterial and fungal isolates. Among the fungal isolates, Aspergillus species accounted for 66.6% (20/30) followed by Fusarium species, which were seen in 26.6% (8/30). Among the bacterial isolates, gram negative organisms were the most common seen in 54.5% (24/44) and the commonest species isolated was Pseudomonas aeruginosa from 27% (12/44) of the stents. Staphylococcus aureus was the commonest gram positive isolate accounting for 18% of all the bacterial isolates. Gram positive organisms were commonly sensitive to cephalosporins and vancomycin whereas gram negative organisms were sensitive to quinolones and aminoglycosides. The surgical success rate was 96% (48/50).Conclusions: Fungal isolates were cultured from significant number of stents retrieved following dacryocystorhinostomy. Gram negative organisms are more common as compared to the gram positive. The organisms isolated were not found to influence the success of dacryocystorhinostomy.