Acquired dacryocystitis: Microbiology and conservative therapy

Abstract

The dacryocystitis in adults is mainly caused by postsaccal stenosis of the lacrimal ducts. The banking up of the lacrimal fluid leads to an accumulation of germs and following infection. This report describes the clinical and microbiological findings in a large consecutive series of patients that presented at the outpatient clinic of the 2nd Department of Ophthalmology of the University of Vienna with the signs of acute, chronic recurrent or chronic infections of the lacrimal system between 1983 and the end of 1990. Within the bacterial genus Staphylococci (S. aureus, S. epidermidis and S. saprophyticus) were the most frequently isolated organisms (74 cultures = 50% out of samples with positive cultures). It was quite interesting that a significant number of gram-negative rods (37 = 25.5%) could be isolated. Of these microorganisms Escherichia coli was most frequently growing on special media (17 cases = 11.7%) when cultures were obtained from acute inflamed lacrimal sacs of patients who suffered from chronic recurrent infections. Conservative therapy of purulent dacryocystitis constitutes the last possible preparation for a necessary surgical intervention and therefore the authors want to point out the importance of microbiological examinations so as to optimize antibiotic therapy.

Microbial Flora of Dacryocystitis and its Antibiogram

“…(10) The most common organisms cultured in our study were Staphylococcus species, accounting for 63.15% of the isolates. This percentage compares fairly well with the results of Thicker and Buffam, (11) Huber-Spitzy et al, (12) As stated in the studies of Mahajan and Alexander et al, (1980), Micrococci are increasingly accepted as human pathogens in ocular infections (16). Our study reported 5 (6.5%) strains of Micrococci from the dacryocystitis cases both in the direct Gram stain from the sample and also isolation of Micrococci in culture.…”

Study of microbial growth on silicone tubes after transcanalicular laser-assisted dacryocystorhinostomy and correlation with patency

“…Inflammation and fibrosis may also be secondary to coexisting infectious colonization within the lumen of the lacrimal system (Huber-Spitzy et al, 1992). In a study conducted by Coden et al (1993), culture of lacrimal sac contents or lacrimal sac biopsy revealed positive culture results in 52.5% cases in external DCR.…”

“…Prophylactic antibiotics are known to prevent infection and are associated with a greater success rate of surgery (Huber-Spitzy et al, 1992). Hence these were prescribed in our patients also.…”

“…It has been suggested that inflammation and fibrosis are among the most common causes of blockage of the ostium in operated DCR patients, and this may be secondary to coexisting infection in the lumen of the lacrimal system (Walland et al, 1994;Huber-Spitzy et al, 1992). This has led to considerable research on the organisms associated with dacryocystitis (Bharathi et al, 2008).…”

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

“…Gram-negative and anaerobic organisms have been reported to be present in 20%-27% and 7%-16% of patients with dacryocystitis, respectively (11,17,21,22) , and the incidence of these infections appears to be rising (10) . Gram-negative bacteria, including Pseudomonas aeruginosa, Enterobacter, Citrobacter spp., Haemophilus influenzae, and Escherichia coli, have also been reported as causative agents of dacryocystitis (10) .…”