Bacteriology of chronic dacryocystitis in a tertiary eye care center

To determine the current bacteriology of adult chronic dacryocystitis in a tertiary eye care center and compare it with previously reported studies.

Clinical and microbiological records of patients with diagnosis of chronic dacryocystitis between January 1999 and March 2002 were reviewed for age, sex, lacrimal sac side involved, and culture results. Patients younger than 16 years of age and patients who were receiving any systemic or topical antibiotics were excluded from the study.

One hundred eighty-eight adult patients with an average age of 50.5 years (range, 16 to 91 years), who had a diagnosis of chronic dacryocystitis, were identified. The study was predominated by female subjects (65.4%). Of the cultures from the nasolacrimal sac, 183 (97.3%) were positive for bacteria, with an average of 2.3 (1 to 6) microorganisms. More than 2 microorganisms were present in 66.1% of the cultures, whereas a single microorganism was recovered from 33.9% of the cultures. The majority of microorganisms in our study were Gram-positive bacteria, representing 53.7% of the overall microorganisms cultured with a predominance of Staphylococcus species. Gram-negative bacteria were recovered from 26.0% of the specimens with predominance of Haemophilus influenzae. Anaerobic microorganisms were present in 19.1% of the samples. The most frequently isolated anaerobic microorganisms were Propionibacterium acne and Peptostreptococcus species.

Several bacterial species may be involved in the pathogenesis of chronic dacryocystitis in adults, and the majority of patients harbor multiple microorganisms in their nasolacrimal sacs. The high rate of microorganism-positive lacrimal sac cultures suggests that adult patients should be treated for their infection before any intraocular surgery because of the potential risk of infection.