Bacteriology of Chronic Dacryocystitis and Antibiotic Susceptibility Pattern of Isolated Bacteria

Abstract

Dacryocystitis is the infection and inflammation of the lacrimal sac. The present study was conducted to isolate bacteria causing chronic dacryocystitis and to determine their antimicrobial susceptibility pattern. 0ne hundred and twenty lacrimal swab materials including the patients with the age above 15 years were collected at B.P Koirala Lions Centre for Ophthalmic Studies, TUTH from August 2008 to January 2009 and processed for microbiological investigation and antibiotic susceptibility test. Overall, 106 bacteria of eight (8) different species were isolated from 76.66 % (92/120) culture positive samples, 85.86% showed single and 14.13% showed mixed growth. CONS were the most common bacteria (P= 0.018), accounted 33.96% followed by Staphylococcus aureus 25.46%, Streptococcus pneumoniae 19.81%, Viridans Streptococci 5.66%, Escherichia coli 5.66%, Haemophilus spp 4.71%, Streptococcus pyogenes 3.77% and Bacillus spp. 0.94%. Staphylococcus aureus were most predominant bacteria in mixed growth. Rate of infection was higher in males 81.39% than females 74.02% but there was no significant difference of infection between males and females (P=0.360). Infection was higher in age group ≥ 31. The mean age calculated was 43.40 years and 50.02 years in male and female respectively. The ratio of unilateral to bilateral infection was found to be 5.3: 1. In antimicrobial susceptibility test, except Staphylococcus aureus, all tested Gram positive isolates were 100% sensitive to Chloramphenicol and were least sensitive to Tobramycin, but Gram negative isolates were equally sensitive to Chloramphenicol and Nalidixic acid. Frequency of isolation of Gram positive organisms were higher than Gram negative organisms. Coagulase negative Staphylococci were most frequently isolated bacteria among all isolates and Staphylococcus aureus were most predominant bacteria in mixed growth. Chloramphenicol was found to be most effective drug of choice for chronic dacryocystitis.

Key words: Chronic dacryocystitis, Nasolacrimal duct, Lacrimal sac, Epiphora, Mucopurulent, Mucoid