Bacteriological profile in conjunctival, lacrimal sac, and nasal specimens and conjunctival normalization time following external, endoscopic, and transcanalicular multidiode laser dacryocystorhinostomy

Abstract

Purpose: To compare the conjunctival, lacrimal sac, and nasal flora cultures and conjunctival normalization time following external (EX-), endoscopic (EN-), and transcanalicular multidiode laser (TC-) dacryocystorhinostomy (DCR) and to evaluate the relationship between culture positivity and surgical success. We further performed antibiotic sensitivity analyses for lacrimal sac culture samples. Methods: A total of 90 patients with primary acquired nasolacrimal duct obstruction were recruited and divided into EX-DCR (n=32), EN-DCR (n=28), and TC-DCR (n=30) groups. Conjunctival, nasal, and lacrimal sac cultures and antibiograms were analyzed. Results: In all three groups, coagulase-negative Staphylococcus (CNS) was predominantly isolated preoperatively from the conjunctiva, nose, and lacrimal sac and postoperatively from the conjunctiva. Preoperative and postoperative conjunctival culture positivity rates were similar between all the groups (p>0.05). A statistically significant difference in the growth rate of culture in the lacrimal sac was observed between the three groups (p=0.001). CNS and Staphylococcus aureus cultures were predominantly sensitive to linezolid, teicoplanin, tigecycline, vancomycin, and mupirocin. Conjunctival normalization times were similar between the three groups (p>0.05). Anatomical and functional success rates were not found to be significantly correlated with preoperative conjunctival and lacrimal sac culture positivity (p>0.05). Conclusions: Similar rates of preoperative and 1-week postoperative conjunctival culture positivity were observed in all the groups; a significantly lower bacterial growth rate was observed in postoperative conjunctival cultures. CNS was the most commonly isolated organism. Bacterial growth rates in the lacrimal sac samples were significantly higher in the EN-DCR group. Bacterial growth rates obtained preoperatively from the conjunctival and lacrimal sac culture samples were not correlated with DCR success.Keywords: Conjunctiva; Dacryocystorhinostomy; Nasolacrimal duct; Antibiotic sensitivity tests; Staphylococcus aureus, Transcanalicular multidiode laser RESUMO Objetivo: Comparar a flora conjuntival, do saco lacrimal e nasal com o tempo de normalização após dacriocistorrinostomia (DCR) externa (EX-), endoscópica (EN-) e transcanalicular a laser de multi diodo (TC-) para correlacionar a positividade da cultura com o sucesso cirúrgico, assim como identificar a sensibilidade aos antibió-ticos em amostras de saco lacrimal. Métodos: Neste estudo prospectivo, 90 pacientes com obstrução do canal nasolacrimal adquirida primária foram incluídos e divididos em grupos EX-DCR (n=32), EN-DCR (n=28) e TC-DCR (n=30). Culturas e antibiogramas conjuntivais, nasais e do saco lacrimal foram analisados. Resultados: Staphylococcus coagulase-negativo (CNS) foi o organismo predominante isolado no pré-operatório (conjuntiva e nariz), no transoperatório (saco lacrimal) e pós-operatório (conjuntiva), nos 3 grupos. Taxas de positividade de cultura da conjuntiva pré-e pós-operat...

Impact of Post-Surgical Therapies on Endoscopic and External Dacryocystorhinostomy: Systematic Review and Meta-Analysis

“…61 However, Balikoglu-Yilmaz et al reported no significant association between pre-operative conjunctival and lacrimal sac bacterial growth and the success rate of DCR. 62 Considering these divergent opinions, in the END-DCR series reported in our study, all publications describe the application of ocular antibiotics and in 64% was associated with systemic antibiotic therapy but with no significant influence on the surgical outcome (p ¼ 0.45). Considering EXT-DCR, 50% of studies described the use of systemic antibiotics, 67% ocular antibiotics and 17% nasal antibiotics; only 1 EXT-DCR study avoided any specific type of local or systemic therapy.…”

Laser nasal surgery (Review)

“…A study on conjunctival and lacrimal sac specimens before and after dacryocystorhinostomy, with Staphylococcus aureus being the primarily isolated bacterium, revealed a decreased growth rate and a change in antibiotic sensitivity following external, endoscopic and trans-canalicular multidiode laser surgery. These findings may be extrapolated to show the benefits of laser surgery in other nasal and paranasal cavity disorders ( 38 ).…”

Actividad antimicrobiana de extractos de plantas frente a Staphylococcus aislados de pacientes con conjuntivitis bacteriana

“…S taphylococcus aureus, Streptococcus pneumoniae y Haemophilus influenzae son los patógenos que con mayor frecuencia causan las conjuntivitis bacterianas (1)(2)(3). Sin embargo, existe una amplia variedad de bacterias oportunistas, especialmente de la microbiota de piel y mucosas, que está asociada con infecciones de la superficie ocular, y dentro de las cuales el Staphylococcus epidermidis es la especie de estafilococos coagulasa negativos (ecn) más identificada (>50 %) en la conjuntivitis bacteriana 75 % (4,5).…”