A Study of Microbiological Profile in Congenital Nasolacrimal Duct Obstruction in a Tertiary Hospital in Nepal

Abstract

  Introduction: Congenital nasolacrimal duct obstruction (CNLDO) is a relatively common condition in pediatric age group mainly due to persistence of membrane in distal portion of nasolacrimal duct causing excessive tearing in the first year of life. The purpose of the study was to identify the microorganisms infecting lacrimal sac secondary to CNLDO and to determine appropriate antimicrobial agent based on sensitivity pattern of isolated microorganisms.

Method: A prospective observational study with sample size 50 was done in Oculoplasty Department of Nepal Eye Hospital from July 2018 to January 2020. A structured proforma was used to record all necessary information of the patients. The mucopurulent discharge from lacrimal punctum or the underlying conjunctiva was cultured and infectious agents were isolated. Susceptibility testing was done by Kirby-Bauer disk diffusion method for different antibiotics.

Result: The culture and sensitivity results of lacrimal drainage system discharge sample of 50 patients with CNLDO were reviewed. Maximum cases were found to be sterile. Common bacteria isolated were Staphylococcous aureus (22%) followed by Streptococcous pneumonia (6%) and Haemophilus influenzae (4%). Gram positive organisms were sensitive to Ofloxacin, Chloramphenicol, Ciprofloxacin, Amoxicillin and Cefixime. Gram negative organisms were sensitive to Ofloxacin and Ciprofloxacin.

Conclusion: Staphyococcous aureus is the commonest Gram positive organism and Hemophillus influenzae is commonest Gram negative organism in infants with CNLDO under 1 year of age. Microbiological analysis and antibiotic sensitivity pattern are useful for selection of antibiotics and to control the further resistance development of bacterial strains.