Pornpanich Kanograt, Luemsamran Panitee, Leelaporn Amornrut, Santisuk Jiraporn, Tesavibul Nattaporn, Lertsuwanroj Buntitar, Vangveeravong Sumalee
Department of Ophthalmology, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Microbiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Clin Ophthalmol. 2016 Feb 22;10:337-42. doi: 10.2147/OPTH.S100280. eCollection 2016.
The aim of this study was to determine the microbiology of primary acquired nasolacrimal duct obstruction (PANDO) and its antimicrobial susceptibilities.
Ninety-three patients (100 eyes) diagnosed with PANDO, categorized as acute, chronic dacryocystitis, or simple epiphora, were prospectively enrolled. Lacrimal sac contents were cultured for aerobic and anaerobic bacteria and fungi. Cultured organisms were identified, and antimicrobial susceptibility testing was performed for aerobic bacteria.
Seventy-nine of the 100 samples were culture positive. One hundred twenty-seven organisms were isolated, and 29 different species were identified. Most microorganisms were Gram-positive bacteria (45 samples or 57.0% of all positive culture samples), whereas Gram-negative bacteria, anaerobic bacteria, and fungi were found in 39 (49.4%), 24 (30.4%), and four samples (5.1%), respectively. The most frequently isolated group was coagulase-negative staphylococci (27.8%), followed by nonspore-forming Gram-positive rods (anaerobe) (17.7%) and Pseudomonas aeruginosa (15.2%). Of the 100 samples, five, 45, and 50 samples were obtained from patients with acute dacryocystitis, chronic dacryocystitis, and simple epiphora, respectively. Subgroup analysis showed that Gram-negative organisms were isolated more frequently from the chronic dacryocystitis subgroup than from the simple epiphora subgroup (P=0.012). Antimicrobial susceptibility testing demonstrated that ciprofloxacin was the most effective drug against all Gram-positive and Gram-negative organisms.
Patients with PANDO, with or without clinical signs of lacrimal infection, were culture positive. Gram-negative organisms were frequently isolated, which were different from previous studies. Ciprofloxacin was the most effective agent against all Gram-positive and Gram-negative organisms.
本研究旨在确定原发性获得性鼻泪管阻塞（PANDO）的微生物学特征及其抗菌药敏性。
前瞻性纳入93例（100只眼）诊断为PANDO的患者，分为急性泪囊炎、慢性泪囊炎或单纯溢泪。对泪囊内容物进行需氧菌、厌氧菌和真菌培养。鉴定培养出的微生物，并对需氧菌进行抗菌药敏试验。
100份样本中有79份培养阳性。分离出127株微生物，鉴定出29种不同的菌种。大多数微生物为革兰氏阳性菌（45份样本，占所有阳性培养样本的57.0%），而革兰氏阴性菌、厌氧菌和真菌分别见于39份（49.4%）、24份（30.4%）和4份样本（5.1%）。最常分离出的菌群是凝固酶阴性葡萄球菌（27.8%），其次是非芽孢形成革兰氏阳性杆菌（厌氧菌）（17.7%）和铜绿假单胞菌（15.2%）。100份样本中，分别有5份、45份和50份样本来自急性泪囊炎、慢性泪囊炎和单纯溢泪患者。亚组分析显示，慢性泪囊炎亚组中革兰氏阴性菌的分离频率高于单纯溢泪亚组（P = 0.012）。抗菌药敏试验表明，环丙沙星是针对所有革兰氏阳性菌和革兰氏阴性菌最有效的药物。
PANDO患者，无论有无泪道感染的临床体征，培养均为阳性。革兰氏阴性菌分离率较高，这与以往研究不同。环丙沙星是针对所有革兰氏阳性菌和革兰氏阴性菌最有效的药物。
