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The microbiologic profile of dacryocystitis.

Stella Y Chung1, Leon Rafailov1, Roger E Turbin1

  • 1a Institute of Ophthalmology and Visual Science , Rutgers New Jersey Medical School , Newark , NJ , USA.

Orbit (Amsterdam, Netherlands)
|May 12, 2018
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Summary

Dacryocystitis treatment may fail in up to one-third of patients due to varied bacteria. Cultures are crucial for effective empiric antibiotic therapy in dacryocystitis cases.

Keywords:
Antibioticdacryocystitistherapy

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Dacryocystitis, an infection of the tear sac, is increasingly associated with gram-negative bacteria and methicillin-resistant Staphylococcus aureus.
  • Empirical antibiotic treatment, common in dacryocystitis management, may be less effective due to evolving microbial resistance patterns.

Purpose of the Study:

  • To investigate the current microbiology and antimicrobial susceptibility patterns of dacryocystitis at a single institution.
  • To inform evidence-based treatment guidelines for dacryocystitis.

Main Methods:

  • Retrospective chart review of patients with dacryocystitis from 2007 to 2015.
  • Collection of patient demographics, microbial isolates, and in vitro antimicrobial susceptibility data.
  • Supplementation with external antimicrobial sensitivity data.

Main Results:

  • Staphylococcus aureus was the most frequent isolate (30%), followed by Pseudomonas species (12%) and Propionibacterium acnes (10%).
  • Levofloxacin and amoxicillin/clavulanate showed potential effectiveness, but resistance was observed in 16% and 32% of cases, respectively.
  • Potential for resistance to these agents was noted in an additional 15% and 8% of cases.

Conclusions:

  • The diverse range of causative organisms necessitates caution with routine, non-culture-guided antibiotic therapy for dacryocystitis.
  • Initiating cultures alongside empiric antibiotic treatment can significantly improve patient outcomes.