Bacteriological study of dacryocystitis among patients attending in Menelik II Hospital, Addis Ababa, Ethiopia.

BACKGROUND

Dacryocystitis usually results from blockage of the nasolacrimal duct. The treatment of such obstruction is surgery. There is a fivefold risk of soft tissue infection after open lacrimal surgery without systemic antibiotic prophylaxis that represents a significant risk of failure in lacrimal surgery.

PURPOSE

To determine the current bacteriology of dacryocystitis and their sensitivity to different antibiotics at Menelik II Hospital.

METHOD

Consecutive patients with dacryocystitis who presented to the department of ophthalmology at Menelik II Hospital between May 2004 and September 2005 were included in the study. Each patient was sent for culture and sensitivity test. Culture and sensitivity tests were obtained from Ethiopian National Health Research Institute (ENHRI), Arsho, Black Lion and Emmanuel Higher clinic laboratories.

RESULTS

One hundred fourteen patients, 58 (50.9%) males and 56 (49.1%) females, with dacryocystitis were examined The majority of cases, 82 (71.9%), were under 30 years of age. Positive results were obtained from 91 (79.8%) patients. Gram-positive and gram negative organisms were isolated from 57 (62.6%) and 34 (37.4%) samples respectively. The five most common isolates were Streptococcus pneumoniae (23%), Streptococcus pyogens (14.3%), Staphylococcus aureus (12.1%), Streptococcus viridans (9.9%) and Haemophilus influenzae (9.9%). The antibiotics to which the majority of the isolates sensitive to were chloramphenicol (82.4%), gentamycin (79.1%), erythromycin (68.1%) and tetracycline (61.5%). While Streptococcus pneumoniae was sensitive to chloramphenicol in 95.2%. its sensitivity to tetracycline was 100%. Haemophilus influenzae was sensitive to tetracycline and chloramphenicol in 88.9% and 77.8% respectively.

CONCLUSION

Gram positive organisms were the most common causes of dacryocystitis. Streptococcus pneumoniae and Haemophilus Influenza was the commonest gram positive and gram negative organisms identified respectively. Chloramphenicol and tetracycline were effective against these common organisms and are recommended for the clinical treatment of dacryocystitis.