Vol. 5, Issue 9 (2019)
Dacryocystitis: Bacteriological profile and its management in a tertiary care hospital of Western Uttar Pradesh
Author(s): Amrita Bajpai, Vashishth Mishra, Rajesh Bareja, Manish Kumar Singh
Abstract: Background: Dacryocystitis (acute and chronic) is caused by nasolacrimal duct obstruction and may be associated with structural abnormality, infectious disorder of the eye, and traumatic injury. Objective: To study bacteriological profile in patients with dacryocystitis in a tertiary care hospital of Western Uttar Pradesh for early and more effective treatment. Materials and Methods: A total of 120 patients with acute and chronic dacryocystitis were included for bacteriological investigations. The specimens were obtained by a broth-moistened swab across the lower conjunctival cul-de-sac and punctum by applying pressure over the lacrimal sac area. Surgically excised lacrimal sacs were also collected and subjected to microbiological analysis. Specimens were inoculated on plates of 5% sheep blood agar, chocolate agar and Sabouraud's dextrose agar (SDA) and incubated accordingly. The isolated organisms were identified and under went for antibiotic susceptibility tests using standard procedures. Results: Culture rate was positive in 55% specimens. Most commonly isolated bacteria were Staphylococcus followed by Pseudomonas, Streptococcus and Hemophillus influenzae. There was also high incidence of anaerobic bacterial isolate. In cases of chronic dacryocystitis, Staphylococcus aureus, coagulase negative Staphylococcus and anaerobic bacteria were commonly isolated accounting for nearly 37%. Gatifloxacin (84%) and amikacin (78%) were the most susceptible drugs for bacterial isolates. Conclusions: The microbiological analysis was differing in acute and chronic infections. Both Gram-positive and Gram-negative pathogens along with anaerobes were isolated from the eyes with acute and chronic dacryocystitis. Rural population was more commonly affected with chronic as well as acute dacryocystitis. Gatifloxacin and amikacin were the most sensitive antibiotics that can be used for empirical therapy of dacryocystitis in both acute and chronic dacryocystitis.