State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science; Guangdong Provincial Clinical Research Center for Ocular Diseases, 54 South Xianlie Road, Guangzhou, 510060, China.
Ophthalmologic Center, The Affiliated Kashi Hospital of Sun Yat-Sen University, The First People's Hospital of Kashi Prefecture, Kashi, 844000, China.
Int Ophthalmol. 2023 Sep;43(9):3363-3371. doi: 10.1007/s10792-023-02743-w. Epub 2023 Jun 20.
The aim was to clarify the distributions of bacteria in the conjunctival sac and lacrimal sac in patients with chronic dacryocystitis.
In total, 297 (322 eyes) chronic dacryocystitis patients who underwent nasal endoscopic dacryocystorhinostomy (EN-DCR) were included. Conjunctival sac secretions from the affected eye were collected preoperatively, and lacrimal sac retention fluid from the affected side in the same patient was collected intraoperatively. Bacterial culture and drug sensitivity testing were performed to determine bacterial distributions.
In total, 127 bacterial isolates (49 species) were detected in 123 eyes in the conjunctival group, with a positivity rate of 38.2% (123/322); 85 bacterial isolates (30 species) were detected in 85 eyes in the lacrimal sac group, with a positivity rate of 26.4% (85/322). The positivity rates were significantly different (P = 0.001) between two groups. The gram-negative bacilli proportion in the lacrimal sac group (36/85, 42.4%) was significantly higher than that in the conjunctival sac group (37/127, 29.2%) ( P = 0.047). Positive conjunctival sac secretion culture (123/322) was significantly associated with increased ocular secretion (281/322, 87.3%) (P = 0.002). Among the culture-positive bacteria in the conjunctival sac group and the lacrimal sac group, 30/127, 23.6% and 43/127, 26.7% and 21/85, 24.7% and 20/85, 23.5% were resistant to levofloxacin and tobramycin, respectively.
This study illustrated differences in bacterial distributions between conjunctival sac secretions and retained lacrimal sac fluid in chronic dacryocystitis patients, with a higher proportion of gram-negative bacilli in lacrimal sac secretions. The ocular surface flora in chronic dacryocystitis patients is partially resistant to levofloxacin and tobramycin, which need to be considered by ophthalmologists.
本研究旨在阐明慢性泪囊炎患者的结膜囊和泪囊中细菌的分布情况。
共纳入 297 例（322 只眼）接受鼻内窥镜下泪囊鼻腔吻合术（EN-DCR）的慢性泪囊炎患者。术前采集患眼结膜囊分泌物，术中采集同一患者患侧泪囊潴留液。进行细菌培养和药敏试验以确定细菌分布情况。
共从结膜组的 123 只眼中检测到 127 株（49 种）细菌，阳性率为 38.2%（123/322）；从泪囊组的 85 只眼中检测到 85 株（30 种）细菌，阳性率为 26.4%（85/322）。两组的阳性率差异有统计学意义（P=0.001）。泪囊组的革兰氏阴性杆菌比例（36/85，42.4%）明显高于结膜组（37/127，29.2%）（P=0.047）。阳性结膜囊分泌物培养（123/322）与增加的眼部分泌物（281/322，87.3%）显著相关（P=0.002）。在结膜囊组和泪囊组的培养阳性细菌中，分别有 30/127、23.6%和 43/127、26.7%和 21/85、24.7%和 20/85、23.5%对左氧氟沙星和妥布霉素耐药。
本研究表明，慢性泪囊炎患者的结膜囊分泌物和泪囊潴留液之间的细菌分布存在差异，泪囊中革兰氏阴性杆菌的比例更高。慢性泪囊炎患者的眼表菌群对左氧氟沙星和妥布霉素部分耐药，眼科医生需要考虑这一点。
