Bacteriological evaluation of adult dacryocystitis in Iran
M Etezad Razavi1, M-R Ansari-Astaneh, M Farzadnia
1Khatam-al-Anbia Eye Hospital, Eye Research Center, Mashad University of Medical Science, Mashad, Iran.
Purpose:
To examine the microbiology and antibiogram of specimens from patients with dacryocystitis.
Methods:
A total of 66 samples from lacrimal sac contents of 61 consecutive patients with acute and chronic dacryocystitis were obtained. These specimens were cultured for bacteria with a routine microbiological technique. Antibiograms were acquired from positive cultures.
Results:
A total of 61 patients (12 patients with acute and 49 patients with chronic dacryocystitis) were included in this investigation with the average age of 40 (12-85) years (female = 74% and male = 26%). Five patients were culture-negative and five patients had mixed gram-positive cultures (a total of 66 samples were obtained). The total prevalence of gram-positive, gram-negative, and culture-negative samples were 71.2%, 21.2%, and 7.6%, respectively. The prevalence of gram-positive, gram-negative, and culture-negative samples were 77.4%, 18.9%, and 3.8% in the chronic and 46.2%, 30.8%, and 23.1% in the acute groups, respectively. The most prevalent pathogen in both groups was Staphylococcus epidermis. In 38% of patients the culture results were similar to those of the contralateral conjunctival flora. Gram-negative bacteria had a high sensitivity to ciprofloxacin and cephalexin while the gram-positive ones were highly sensitive to ceftriaxone and ampicillin.
Conclusion:
The responsible pathogens in acute and chronic dacryocystitis are significantly different. Because of the high prevalence of gram-negative bacteria and also culture-negative samples and considering the necessity of treatment in acute dacryocystitis, selecting an appropriate antibiotic with a good coverage of gram-negative and gram-positive bacteria seems essential.
