Microbiology of primary acquired nasolacrimal duct obstruction: simple epiphora, acute dacryocystitis, and chronic dacryocystitis

Abstract

PurposeThe aim of this study was to determine the microbiology of primary acquired nasolacrimal duct obstruction (PANDO) and its antimicrobial susceptibilities.MethodsNinety-three patients (100 eyes) diagnosed with PANDO, categorized as acute, chronic dacryocystitis, or simple epiphora, were prospectively enrolled. Lacrimal sac contents were cultured for aerobic and anaerobic bacteria and fungi. Cultured organisms were identified, and antimicrobial susceptibility testing was performed for aerobic bacteria.ResultsSeventy-nine of the 100 samples were culture positive. One hundred twenty-seven organisms were isolated, and 29 different species were identified. Most microorganisms were Gram-positive bacteria (45 samples or 57.0% of all positive culture samples), whereas Gram-negative bacteria, anaerobic bacteria, and fungi were found in 39 (49.4%), 24 (30.4%), and four samples (5.1%), respectively. The most frequently isolated group was coagulase-negative staphylococci (27.8%), followed by nonspore-forming Gram-positive rods (anaerobe) (17.7%) and Pseudomonas aeruginosa (15.2%). Of the 100 samples, five, 45, and 50 samples were obtained from patients with acute dacryocystitis, chronic dacryocystitis, and simple epiphora, respectively. Subgroup analysis showed that Gram-negative organisms were isolated more frequently from the chronic dacryocystitis subgroup than from the simple epiphora subgroup (P=0.012). Antimicrobial susceptibility testing demonstrated that ciprofloxacin was the most effective drug against all Gram-positive and Gram-negative organisms.ConclusionPatients with PANDO, with or without clinical signs of lacrimal infection, were culture positive. Gram-negative organisms were frequently isolated, which were different from previous studies. Ciprofloxacin was the most effective agent against all Gram-positive and Gram-negative organisms.

Frequency of Bacterial Samples from Patients with Chronic Acquired Nasolacrimal Duct Obstruction

“…The clinical importance of microbial causes of CANDO and pattern of drug resistance is widely recognized as a key part of the treatment strategy in these patients. Similar to the results of previous studies, the authors found that in patients with CANDO, a great variety of bacterial pathogens can be isolated (2-4). Shahrakiet et al found that 46.7% of all samples were negative – normal, and only 6.7% were marked with gram positive bacteria.…”

“…In the results from previous studies, negative cultures were found in 17.8% of patients in Thailand (4), 15.6% in Nepal (3) and only 10% in United States (5). Additionally, in most of previous studies gram positive bacteria were the most predominant in culture positive specimens, from 64.9% to 78.5% (2-4). Thus, Pornpanich et al found that in patients with longer duration of the CANDO symptoms, gram negative cultures become more common (2).…”

“…Additionally, in most of previous studies gram positive bacteria were the most predominant in culture positive specimens, from 64.9% to 78.5% (2-4). Thus, Pornpanich et al found that in patients with longer duration of the CANDO symptoms, gram negative cultures become more common (2). Therefore, these differences might be a result of prolonged previous usage of different local and systemic antibiotics in the present group, which could result in changed bacterial profile and fungal superinfection.…”

Acute dacryocystitis with giant lacrimal abscess: a case report

“…Bacterial cultures from the purulent discharge (sampled at the sac, fistula or abscess surgical incision) are commonly performed [3]; both in children and in adults, the most frequently isolated germ is methicillin-sensitive Staphylococcus aureus, followed by Streptococcus pneumoniae. Gram negative species can be detected in culture positive acute dacryocystitis too [1,6].…”

A Study to Evaluate the Role of Dacryocystogram in Patients With Chronic Dacryocystitis

“…Chronic dacryocystitis is one of the most common causes of epiphora due to insufficient drainage. The insufficient drainage is due to either congenital causes like punctal atresia, diverticulum or fistula from sac to nose or cheek, Nasolacrimal Duct Obstruction (NLD), agenesis or acquired causes 1 processes, chronic disease, dacryoliths, allergy, systemic chemotherapeutic agents, postherpetic infection (Herpes simplex, varicella zoster), bacterial infection (Actinomyces, Chlamydia), Wegener granulomatosis, sarcoidosis, hay fever, atopy, etc.…”