Pattern of Microbial Flora in Chronic Dacryocystitis

Abstract

INTRODUCTION: Dacryocystitis is the result of an acquired nasolacrimal duct stenosis leading to outflow obstruction and subsequent infection and inflammation of retained stagnant contents within the lacrimal sac. Chronic dacryocystitis is a more indolent form of dacryocystitis. The objective of this study was to determine the pattern of microbial flora in chronic dacryocystitis.

METHOD: This was a prospective observational study conducted to determine the pattern of microbial flora of dacryocystitis in patients presenting to the Department of Oculoplasty of Nepal Eye Hospital Tripureshwor over a period of one and half year from June 2016 to December 2017. Sixty patients were enrolled. Lacrimal swabs were taken and sent for culture and sensitivity (C/S) in 4 different media - Blood, Chocolate, MacConkey and Sabouraud Dextrose Agars. Out of 60 patients, 9 (15%) had corneal ulcers who underwent corneal scrapping and the specimens were sent for the same 4 media.

RESULT: Forty percent of lacrimal swab cultures were positive showing growth of organisms. Among positive cultures, 62.6% were Streptococcus pneumoniae, 29.2% were Staphylococcus aureus, 4.2% were Beta hemolytic streptococcus and Streptococcus viridans. Sensitivities of Streptococcus pneumoniae were 93.3%, 86.6%, 86.6%, 80% and 46.6% to Chloramphenicol, Ciprofloxacin, Penicillin, Ceftriaxone and Gentamycin respectively. Only one patient (11%) with corneal ulcer had positive culture.

 CONCLUSION: Streptococcus pneumonia and Staphylococcus aureus are the common micro-organisms in lacrimal swab cultures. Chloramphenicol is an effective drug for the treatment of chronic dacryocystitis followed by Ciprofloxacin, Penicillin, Ceftriaxone and Gentamycin.