Clinicobacteriological Profile of Chronic Dacryocystitis in Adult Patients Attending Ophthalmology Department of a Tertiary Eye Care Hospital: A One Year Cross Sectional Study

Abstract

Background and objectives Dacyrocystitis is one of the most common diseases that bring patients to the ophthalmologist. Most often antibiotics are given empirically as prophylaxis as well as post operatively but the rising incidence of resistant infections as well as a significant increase in failure of open lacrimal sac surgery due to infection demand that more keen attention should be paid to the selection of antibiotics. This study attempts to evaluate the changing trend in bacteriology and antibiotic sensitivity of chronic dacryocystitis. Methods The clinicobacteriological profiles of 55 adult patients coming to Ophthalmology OPD of KLES Dr.Prabhakar Kore Charitable Hospital & MRC, Belgaum, diagnosed with chronic dacryocystitis between January 2013 and December 2013 were included in this cross sectional study .Sample fluid was collected by applying pressure over the lacrimal sac and allowing the fluid/purulent material to reflux through the lacrimal punctum or by irrigating the lacrimal drainage system with sterile saline and collecting the sample from the refluxing material. The samples were sent to microbiology department for Gram’s staining and culture. Antibiotic sensitivity testing was done for the cultured bacterial growth by Kirby Bauer disc diffusion test. Results In our study 43.6% yielded aerobic growth on culture. The commonest aerobic bacteria in chronic dacryocystitis were Staphylococcus aureus (48%) followed by coagulase negative staphylococci (26%). Among Gram negative bacteria Pseudomonas aeruginosa (7%) and Klebsiella pneumonia (7%) were common. Staphylococcus aureus was the most commonly isolated bacteria in mixed bacterial isolates. The Gram-positive isolates were most sensitive to Erythromycin followed by Ciprofloxacin. The gram negative isolates were most sensitive to Ciprofloxacin and Amikacin. Conclusion and interpretation There is an increase in risk of soft tissue infection after open lacrimal surgery without systemic antibiotic prophylaxis. Knowledge about bacteriology of chronic dacryocystitis contributes significantly to choice of prophylactic antimicrobial agents that act specifically on the causative organism and also prevents antibiotic resistance caused due to injudicious use of antibiotics.