Presence of Biofilms in the Lacrimal Sac Mucosa

Abstract

A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The inflammation and the following fibrosis due to the bacterial colonization are thought to be the principle underlying mechanism in the development of nasolacrimal duct stenosis. The aim of this study was to investigate the presence of biofilms in the lacrimal sac mucosa of the patients with dacryostenosis. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : This study included 15 patients with a symptom of epiphora for at least 3 months and documented dacryostenosis with a dacryocystography. Lacrimal sac mucosal specimens obtained during endoscopic dacryocystorhinostomy (DCR) were examined for the presence of biofilm formation under the scanning electron microscope. R Re es su ul lt ts s: : The specimens were obtained from 15 patients. The mean age of 12 female and 3 male patients was 54 years. Epiphora was the main symptom and its average duration was 18 (6-36) months. We could not analyze specimen in 1 patient. We detected biofilm formation in 12 of 14 (% 85.7) specimens. Biofilm formation was dense in 5 specimens and light in 7 specimens. C Co on nc cl lu us si io on n: : This is the first article that documents the presence of bacterial biofilms on the lacrimal sac mucosa in the patients with dacryostenosis. This study shows the presence of biofilms in cases with dacryostenosis and interrogates its role in the etiology of chronic dacryocystitis similar to other chronic infections. Further investigations on this subject should be carried on in larger and controlled series to assure the role of biofilms in the etiology of chronic infections. New studies should also investigate whether the biofilm formation is the reason or the result of chronic infections. We believe that, control of biofilm formation in chronic infections would prevent secondary problems like the development of dacryostenosis.K Ke ey y W Wo or rd ds s: : Biofilms; dacryocystitis; microscopy, electron, scanning; dacryocystorhinostomy Ö ÖZ ZE ET T A Am ma aç ç: : Bakteriyel kolonizasyon sonucu gelişen inflamasyon ve fibrozis, nazolakrimal kanal stenozuna yol açan temel mekanizma olarak kabul edilmektedir. Bu çalışmanın amacı, dakriostenozlu olguların lakrimal kese mukozalarında biofilm varlığını araştırmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu çalışmaya en az 3 aydır epifora şikayeti olan ve dakriosistografide dakriostenoz tespit edilen 15 olgu dahil edilmiştir. Endoskopik dakriosistorinostomi sırasında elde edilen lakrimal kese mukoza örnekleri, tarayıcı elektron mikroskopide incelenerek biyofilm varlığı araştırılmıştır. B Bu ul lg gu ul la ar r: : Ortalama yaşı 54 olan 12 kadın ve 3 erkek, toplam 15 hasta çalışmaya dahil edilmiştir. Hastalarda görülen en sık semptom epifora idi ve ortalama 18 aydır mevcuttu. İncelenen 14 spesmenin 12 (%85,7)'sinde biyofilm tespit edildi. Spesmenlerin 1 tanesinin analizi yapılamadı. Biyofilm formasyonu örneklerin 5'inde hafif, 7'sinde ise yoğun idi. S So on nu uç ç: : Bu makale dakriostenozlu hastaların lakrimal kese muko...

Biofilm Quantification on Nasolacrimal Silastic Stents After Dacryocystorhinostomy

“…This prospective pilot study of patients undergoing routine DCR with silicone stent placement showed that at 4 weeks postsurgery all stents had readily acquired biofilm structures on their external surface. Confocal laser scanning microscopy showed polymicrobial biofilms with significant variation in distribution and morphology, which is consistent with previous studies 9, 17 The first documentation of biofilms demonstrable on lacrimal mucosa was by KoşArsoy et al 11 and their article described biofilms adhering to lacrimal sac mucosa in 75% of patients with dacryocystitis and in 90% of patients without dacryocystitis. Although they made an attempt to grade biofilm intensity as light or dense using SEM, it should be noted that this imaging modality is highly subjective, nonquantitative, and also only assesses topographic coverage.…”

“…6 Biofilms also commonly form on implantable medical materials such as central venous catheters, urinary catheters, and tympanostomy tubes and are believed to be responsible for prosthesis related infections. [8][9][10] KoşArsoy et al 11 studied lacrimal sac mucosa during DCR and demonstrated biofilm structures to be significantly prevalent in patients with and without acute dacryocystitis. Similarly, 2 studies exist demonstrating biofilms on stents used at the time of DCR, but were only assessed after clinical soft tissue infection, and at varying in vivo times.…”

Biofilm colonization in chronic treatment refractory infections presenting with discharging sinuses: A study in a tertiary care hospital of Eastern India

“…[ 19 ] In a study reported by Kosarsoy et al ., BF was detected by SEM in 12 out of 14 (85.7%) specimens from lacrimal mucosa of cases of chronic dacryocystitis. [ 25 ] Culture-directed optimal antibiotic treatment during acute stages may prevent BF colonization. Once colonization has occurred, lacrimal syringing, and dacryocystorhinostomy/dacryocystectomy (mechanical removal of focus) remain the main modality of treatment.…”