Mandal Radhakrishna, Banerjee Asit Ranjan, Biswas Mukul Chandra, Mondal Anindita, Kundu Pratip Kumar, Sasmal Nirmal Kumar
Department of Ophthalmology, NRS Medical College, Kolkata 700014.
J Indian Med Assoc. 2008 May;106(5):296-8.
Chronic dacryocystitis is the inflammation of lacrimal sac, frequently caused by bacteria. Obstruction of nasolacrimal duct converts the lacrimal sac a reservoir of infection. It is a constant threat to cornea and orbital soft tissue. Moreover, it causes social embarrassment due to chronic watering from the eye. This study was conducted to find out the current clinicobacteriological profile of chronic dacryocystitis in adults. A total of 56 adult patients were selected from ophthalmology OPD. Detail history and clinical examinations were carried out. All patients underwent either dacryocystorhinostomy or dacryocystectomy. A part of the sac was collected for culture and sensitivity. This study revealed that chronic dacryocystitis is more common in females and left eye is more frequently involved than right eye. It is common among lower socioeconomic strata with habit of pond-bathing. Some form of nasal pathology like hypertrophied inferior turbinate, deviated nasal septum, nasal polyp and allergic rhinitis werefound in 19.6% of the patients. Complications of chronic dacryocystitis like conjunctivitis, corneal ulcer, acute on chronic dacryocystitis, lacrimal abscess and fistula were seen in 25.0% of these patients; 53.6% of the culture samples were positive for bacterial growth. Gram-positive organisms were most common isolate. Unlike other studies, Staphylococcus aureus (40.0%) was found to be most common Gram-positive organism, followed by Staphylococcus epidermidis (10.0%) and Steptococcus pneumoniae (10.0%). Among the Gram-negative organisms, Pseudomonas aeruginosa (16.6%) was the most common, followed by Klebsiella pneumoniae (6.6%) and Haemophilus influenzae (6.6%). Antibiotic sensitivity tests were done. Most of the organisms were resistant to penicillin. Chloramphenicol was effective against most of the Gram-positive organisms. Aminoglycosides, tobramycin in particular, was effective against Staphylococcus epidermidis. Fluoroquinolones, namely ciprofloxacin and ofloxacin were effective against Pseudomonas aeruginosa and Klebsiella pneumoniae.
慢性泪囊炎是泪囊的炎症，常由细菌引起。鼻泪管阻塞使泪囊成为感染源。它对角膜和眼眶软组织构成持续威胁。此外，由于眼睛长期流泪，还会造成社交尴尬。本研究旨在了解成人慢性泪囊炎目前的临床细菌学特征。从眼科门诊共选取了56例成年患者。进行了详细的病史询问和临床检查。所有患者均接受了泪囊鼻腔吻合术或泪囊摘除术。采集部分泪囊组织进行培养和药敏试验。本研究表明，慢性泪囊炎在女性中更为常见，左眼比右眼更易受累。在社会经济地位较低且有池塘沐浴习惯的人群中较为常见。19.6%的患者存在某种形式的鼻腔病变，如下鼻甲肥大、鼻中隔偏曲、鼻息肉和过敏性鼻炎。25.0%的患者出现了慢性泪囊炎的并发症，如结膜炎、角膜溃疡、慢性泪囊炎急性发作、泪囊脓肿和瘘管；53.6%的培养样本细菌生长呈阳性。革兰氏阳性菌是最常见的分离菌。与其他研究不同，金黄色葡萄球菌（40.0%）是最常见的革兰氏阳性菌，其次是表皮葡萄球菌（10.0%）和肺炎链球菌（10.0%）。在革兰氏阴性菌中，铜绿假单胞菌（16.6%）最为常见，其次是肺炎克雷伯菌（6.6%）和流感嗜血杆菌（6.6%）。进行了抗生素药敏试验。大多数细菌对青霉素耐药。氯霉素对大多数革兰氏阳性菌有效。氨基糖苷类，特别是妥布霉素，对表皮葡萄球菌有效。氟喹诺酮类，即环丙沙星和氧氟沙星，对铜绿假单胞菌和肺炎克雷伯菌有效。
