Study on the Effectiveness of Antibiotic Prophylaxis in External Dacryocystorhinostomy: A Review of 697 Cases

Pinar-Sueiro, Sergio; Fernández-Hermida, Roberto-Víctor; Gibelalde, A.; Martínez-Indart, Lorea

doi:10.1097/iop.0b013e3181d644cf

Cited by 30 publications

(20 citation statements)

References 22 publications

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“…As an oral antibiotic, generally 3rd generation fluoroquinolons or extended-spectrum penicillin derivatives (cephalosporins, amoxicillin/clavulanic acid) are preferred. [15][16][17][18] In our study, all gram-positive isolates were susceptible to vancomycin, teicoplanin and linezolide. Besides, 96-100% of the microorganisms -excluding MRCNS-are susceptible to levofloxacin.…”

Section: Discussionsupporting

confidence: 46%

Clinical and microbiological evaluation of the culture results of the patients with chronic dacryocystitis at a tertiary care hospital

Gümüşsoy¹,

Çukurova²,

Ece³

et al. 2016

ENT Updates

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Amaç: Bu çal›flmada, kronik dakriyosistitli hastalardan izole edilen örnekler yard›m›yla farkl› anatomik bölgeler ile bunlar›n antibiyotik duyarl›l›¤› aras›ndaki iliflkinin incelenmesi amaçlanm›flt›r.Yöntem: Kronik dakriyosistit tan›s› konmufl ve Mart 2013 ile May›s 2014 aras›nda endoskopik endonazal dakriyosistorinostomi ameliyat› geçiren 50 hasta çal›flma kapsam›na al›nd›. Swab örnekleri konjunktiva ve alt nazal meatustan ameliyat öncesi, lakrimal kese örnekleri ise ameliyat s›ras›nda al›nd›. ‹zole edilmifl örneklerin tan›mlanmas›nda ve antibiyotik duyarl›l›¤›n›n belirlenmesinde Vitek version 2.0 sistemleri kullan›ld› (BioMeriuex Inc., Marcy-l'Étoile, Fransa). Bulgular:Otuz dokuzu kad›n (%78), 11'i erkek (%22) toplam 150 hasta ameliyat edildi ve kendilerinden swab örnekleri al›nd›. Kültür örneklerinin 136's›nda (%90.6) bakteri geliflimi saptanm›flt›r. Kültür ortam›nda tek (n=125; %91.9) veya iki farkl› (n=11; %9.1) mikroorganizma ekimi yap›ld›. Gram-pozitif ve gram-negatif örneklerin da¤›l›-m› s›ras›yla %61.9 (n=91) ve %38.1 (n=56) oldu. En çok rastlanan gram-pozitif örnek Staphylococcus idi. Gram-negatif izolatlar 3. nesil sefalosporinlere, sefepime ve karbapenemlere duyarl›l›k gösterirken gram-pozitif izolatlar vankomisin, teikoplana ve linezolide duyarl›l›k gösterdi.Sonuç: Metisilin duyarl› koagülaz-negatif Staphylococci ve metisilin dirençli koagülaz-negatif Staphylococci için bakteri büyümesi, konjonktiva, lakrimal kese ve alt meatus olmak üzere üç bölgede benzerlik göstermifltir. Baflka bir deyiflle bu mikro-organizmalar›n bir lokasyonda büyümesi baflka bir lokasyonda da h›zla büyüyebileceklerini göstermektedir.Anahtar sözcükler: Kronik dakriyosistit, konjonktiva floras›, lakrimal kese, kültür. AbstractObjective: In this study, we aimed to evaluate the isolated strains from the patients with chronic dacryocystitis and the relationship between different anatomical areas and their antibiotic susceptibilities.Methods: Fifty patients diagnosed with chronic dacryocystitis were included. Fifty patients underwent endoscopic endonasal dacryocystorhinostomy from March 2013 to April 2014. Swab samples were obtained from conjunctiva and inferior nasal meatus before surgery, obtained from lacrimal sac during surgery. Identification and antibiotic susceptibility of the isolated strains were performed by automated Vitek version 2.0 systems (BioMeriuex Inc., Marcy-l'Étoile, France). Results:A total of 39 (78%) female and 11 (22%) male patients were operated and 150 swab samples were evaluated. Bacterial growth was detected in 136 (90.6%) culture samples. A single (n=125; 91.9%) or two different (n=11; 9.1%) microorganisms were grown on culture media. The distribution of gram-positive strains (n=91) and gram-negative strains (n=56) were 61.90% and (38.10%), respectively. The most frequently isolated gram-positive isolate was Staphylococcus. Gram-negative isolates were susceptible to third-generation cephalosporins, cefepime and carbapenems while gram-positive isolates were susceptible to vancomycin, teicoplanin and linez...

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Section: Discussionsupporting

confidence: 46%

Clinical and microbiological evaluation of the culture results of the patients with chronic dacryocystitis at a tertiary care hospital

Gümüşsoy¹,

Çukurova²,

Ece³

et al. 2016

ENT Updates

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“…Dacryoadenitis frequently occurs in the newborn and in elderly women 25,26. In this study, there was 1 female infant (2 months old female) and nine of the ten patients were aged 60 years or older.…”

Section: Discussionmentioning

confidence: 71%

Prevalence of drug resistance and culture-positive rate among microorganisms isolated from patients with ocular infections over a 4-year period

Shimizu¹,

Toshida²,

Honda³

et al. 2013

OPTH

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PurposeTo investigate the microbial isolates from patients with ocular infections and the trend in the emergence of levofloxacin-resistant strains over the past four years from 2006 to 2009 retrospectively.Patients and methodsThe subjects were 242 patients with ocular infections or traumas treated in our hospital including outpatients, inpatients, and emergency room patients. Most of them needed urgent care presenting with eye complaints, traumas, or decreased vision. Clinical samples were obtained from discharges, corneal, conjunctival tissues or vitreous fluid or aqueous humor, and cultured. Items for assessment included the patient’s age, the diagnosis, the prevalence of isolated bacteria, and the results of susceptibility tests for levofloxacin (LVFX) cefamezin (CEZ), gentamicin (GM) and vancomycin. This information was obtained from the patients’ medical records.ResultsThere were 156 male patients and 86 female patients who were aged from 2 months old to 94 years old and mean age was 56.8 ± 24.2 years. Of the 242 patients, 78 (32.2%) had positive cultures. The culture-positive rate was significantly higher in male patients than female in total (P = 0.002) and in patients with corneal perforation (P = 0.005). Corneal perforation was the highest culture-positive rate (60.0%), followed by orbital cellulitis (56.5%), blepharitis (50.0%), dacryoadenitis (45.5%), conjunctivitis (38.2%), infectious corneal ulcer (28.5%) and endophthalmitis (24.7%). LVFX-resistant strains accounted for 40 out of a total of 122 strains (32.8%), and the minimum inhibitory concentration (MIC) was significantly higher in LVFX and GM compared with the other antibiotics. There were no vancomycin-resistant strains.ConclusionAttention should be paid to a possible future increase of strains with resistance to LVFX, as commonly prescribed ocular antibiotics bring emergence of resistant bacteria. Although no vancomycin-resistant strains were isolated this drug should be reserved as the last resort, in order to prevent the emergence of vancomycin resistance.

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“…However, we defined conjunctival normalization time, which differs from the definitions for the same in the two above-mentioned studies (15,26) . Pinar-Sueiro et al reviewed the clinical records of 697 patients who had undergone EX-DCR and found S. aureus to be most sensitive to gentamicin, co-trimoxazole, rifampicin, clindamycin, vancomycin, tobramycin, mupirocin, cefuroxime-axetil, chloramphenicol, te tracycline, fusidic acid, and cefalotin (100% sensitivity to all), while penicillin demonstrated the worst activity against S. aureus with 83.3% resistance (27) . In a study by Pradeep et al (18) , antibiogram results demonstrated that Staphylococci represented the majority of cultured organisms (85%), and the most effective antibiotics against it were vancomycin, amikacin, third-generation cephalosporins, and amoxyclav (100%, 89%, 83%, and 78% sensitivity, respectively).…”

Section: Discussionmentioning

confidence: 99%

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

Balikoglu-Yilmaz¹,

Esen²,

Yılmaz³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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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...

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Study on the Effectiveness of Antibiotic Prophylaxis in External Dacryocystorhinostomy: A Review of 697 Cases

Abstract: This study questions the generalized use of prophylactic antibiotics for external dacryocystorhinostomy, while providing evidence to indicate their use for patients who have had prior episodes of mucocele, mucopyocele, or acute dacryocystitis.

Cited by 30 publications

References 22 publications

Clinical and microbiological evaluation of the culture results of the patients with chronic dacryocystitis at a tertiary care hospital

Clinical and microbiological evaluation of the culture results of the patients with chronic dacryocystitis at a tertiary care hospital

Prevalence of drug resistance and culture-positive rate among microorganisms isolated from patients with ocular infections over a 4-year period

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

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