Microbiological spectrum of microbial keratitis in patients presenting with nasolacrimal duct obstruction

2020 ◽  
pp. 112067212094057
Author(s):  
Supriya Sharma ◽  
Srikant K Sahu ◽  
Suryasnata Rath ◽  
Aparajita Mallick ◽  
Savitri Sharma ◽  
...  

Purpose: To study the type of bacteria and their antibiotic susceptibility pattern from corneal scrapings of patients with infectious keratitis presenting with concurrent nasolacrimal duct obstruction. Methods: A retrospective analysis was carried out of patients with microbial keratitis and co-existing nasolacrimal duct obstruction during a 5-year period (January 2012 to December 2016). Antibiotic susceptibility profile data was collected from the microbiology records. Results: The study included 56 (M:F = 33:23; OD:OS = 34:22) eyes. The mean age of patients was 60.2 ± 12.3 years. Microscopic examination of corneal scrapings showed 52% of gram-positive ( n = 29/55) and 2% of multiple (>1; n = 1/55) bacteria. Streptococcus pneumoniae (32%, n = 18/56), coagulase-negative Staphylococcus (25%, n = 14/56), and Staphylococcus aureus (11%, n = 6/56) were the most common bacteria. Streptococcus pneumoniae was found to be susceptible to ciprofloxacin (72.2%), ofloxacin (94.4%), gatifloxacin (61.1%), and moxifloxacin (83.3%). Conclusion: Corneal infection associated with nasolacrimal duct obstruction is commonly caused by gram-positive-bacteria. Irrigation of nasolacrimal duct should be mandatory test in microbial keratitis. The gram-positive bacteria isolated showed maximum susceptibility to vancomycin and cefazolin. Early treatment by surgery and appropriate medical management is recommended for its control.

2020 ◽  
pp. 1-4
Author(s):  
N. V. N Prasanna Bharathi ◽  
P. Ramdas ◽  
M. Padma ◽  
Sowmya Andole

AIM: To study and evaluate the different organisms that are responsible for congenital nasolacrimal duct obstruction .To initiate appropriate antimicrobials based on the sensitivity patterns of the isolated organisms. Methods: It is a prospective study conducted in Sarojini Devi Eye hospital during September 2016 to February 2018. 112 samples from 100 cases were collected from clinically diagnosed congenital nasolacrimal duct obstruction with epiphora below 1 year without any ocular and systemic diseases .Swabs taken were analysed for causative microorganisms of congenital nasolacrimal duct obstruction. Results: In our study out of 112 samples[88 unilateral cases+12 bilateral cases ]82 cases [73.21%] were culture positive, of which80 [71.42%]were bacterial,2 cases [1.78%]were mixed [ bacterial +fungal].Gram positive bacteria were predominant, staphylococcus epidermidis 56[68.29%] followed by Staphylococcus aureus 13[15.85%].Among gram negative bacteria Escherichia coli 1 [1.21%], klebsiella 1[1.21%]. 2 cases were mixed [bacteria +fungal]. Infection is more commonly seen in right eye. Rate of infection was higher in females 62[55.35].Higher incidence of infection was seen in the age group of less than 7 months. Both gram positive and gram negative were most susceptible to tobramycin. Conclusion: Among all the congenital nasolacrimal duct obstructions 90% of the cases would resolve spontaneously with medical therapy and Criggler massage. 10 % of the cases require probing and silicon tube intubation. The knowledge of identification , awareness and bacteriology of congenital nasolacrimal duct obstruction by the paediatricians , physicians and the parents would contribute to the choice of effective antimicrobials and reduce keratitis medicamentosa ,induced astigmatism due to excessive eye rubbing and apprehension among the parents.


2020 ◽  
Author(s):  
Xiaoyu Zheng ◽  
Bonnie Nga Kwan Choy ◽  
Mingming Zhou ◽  
Caiping Shi ◽  
Zhengyan Zhao

Abstract Background: Congenital nasolacrimal duct obstruction (CNLDO) is one of the main causes of epiphora in infants, and antibiotics are usually used as a conservative therapy in the first year. Yet, little is known about the bacteriology of the occluded lacrimal drainage system in this group of patients. The aim of this study was to evaluate the microbiology of lacrimal sac (LS) in Chinese children with CNLDO in their first year of life.Methods: Patients with CNLDO between May 1, 2017 and August 31, 2018 at a tertiary care children’s hospital were enrolled. The study recruited infants who received lacrimal probing under 1 year old, and refluxed discharge from LS was collected. Samples were cultured and susceptibility test was performed for positive culture.Results: Thirty-two patients with CNLDO were included. The ratio of male to female was 23:9. The mean age was 6.7 ± 2.4 (1.7-12) months. Positive cultures was identified in 87.5% of the sample, and presented 38 strains of bacteria. Mixed infection was identified in 10 (31.3%) children. Gram-positive bacteria accounted for 60.5% of all the strains, with Streptococcus (50%) being the most frequent species, whereas Haemophilus (21.1%) and Neisseriae (13.2%) were most common isolates for Gram-negative organisms. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 2 infants whose symptoms resolved by a routine probing. No difference of bacteriology pattern was detected between patients under 6 months old and those beyond. The pathogens were highly sensitive to chloramphenicol (88%) and levofloxacin (84%), but resistant to erythromycin (40%) and sulfamethoxazole (32%).Conclusions: Infants with CNLDO under 1 year of age presented predominance of Streptococcus as Gram-positive organism, and Haemophilus as Gram-negative organism. Levofloxacin was an active topical antibiotic agent with few chance of resistance especially for Chinese children. These findings could help clinicians choose optimal medicine for CNLDO as the conservative treatments.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiao-Yu Zheng ◽  
Bonnie Nga Kwan Choy ◽  
Ming-Ming Zhou ◽  
Cai-Ping Shi ◽  
Zheng-Yan Zhao

Abstract Background Congenital nasolacrimal duct obstruction (CNLDO) is one of the main causes of epiphora in infants, and antibiotics are usually used as a conservative therapy in the first year. Yet, little is known about the bacteriology of the occluded lacrimal drainage system in this group of patients. The aim of this study was to evaluate the microbiology of lacrimal sac (LS) in Chinese children with CNLDO in their first year of life. Methods Patients with CNLDO between May 1, 2017 and August 31, 2018 at a tertiary care children’s hospital were enrolled. The study recruited infants who received lacrimal probing under 1 year old, and refluxed discharge from LS was collected. Samples were cultured and susceptibility test was performed for positive culture. Results Thirty-two patients with CNLDO were included. The ratio of male to female was 23:9. The mean age was 6.7 ± 2.4 (1.7–12) months. Positive cultures was identified in 87.5% of the sample, and presented 38 strains of bacteria. Mixed infection was identified in 10 (31.3%) children. Gram-positive bacteria accounted for 60.5% of all the strains, with Streptococcus (50%) being the most frequent species, whereas Haemophilus (21.1%) and Neisseriae (13.2%) were most common isolates for Gram-negative organisms. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 2 infants whose symptoms resolved by a routine probing. No difference of bacteriology pattern was detected between patients under 6 months old and those beyond. The pathogens were highly sensitive to chloramphenicol (88%) and levofloxacin (84%), but resistant to erythromycin (40%) and sulfamethoxazole (32%). Conclusions Infants with CNLDO under 1 year of age presented predominance of Streptococcus as Gram-positive organism, and Haemophilus as Gram-negative organism. Levofloxacin was an active topical antibiotic agent with few chance of resistance especially for Chinese children. These findings could help clinicians choose optimal medicine for CNLDO as the conservative treatments.


Cornea ◽  
2019 ◽  
Vol 38 (1) ◽  
pp. 84-88
Author(s):  
Arpita Nayak ◽  
Sanchita Mitra Basu ◽  
Anuria De ◽  
Aparajita Mallick ◽  
Sujata Das ◽  
...  

2020 ◽  
Author(s):  
Xiaoyu Zheng ◽  
Bonnie Nga Kwan Choy ◽  
Mingming Zhou ◽  
Caiping Shi ◽  
Zhengyan Zhao

Abstract Background Congenital nasolacrimal duct obstruction (CNLDO) is one of the main causes of epiphora in infants, and antibiotics are usually used as a conservative therapy in the first year. Yet, little is known about the bacteriology of the occluded lacrimal drainage system in this group of patients. The aim of this study was to evaluate the microbiology of lacrimal sac (LS) in Chinese children with CNLDO in their first year of life. Methods Patients with CNLDO between May 1, 2017 and August 31, 2018 at a tertiary care children’s hospital were enrolled. The study recruited infants who received lacrimal probing under 1 year old, and refluxed discharge from LS was collected. Samples were cultured and susceptibility test was performed for positive culture. Results Thirty-two patients with CNLDO were included. The ratio of male to female was 1.5 : 1. The mean age was 6.6 ± 2.3 (1.7–12) months. Positive cultures was identified in 87.5% of the sample, and presented 38 strains of bacteria. Mixed infection was identified in 10 (35.7%) children. Gram-positive bacteria accounted for 60.5% of all the strains, with Streptococcus (50%) being the most frequent species, whereas Haemophilus (21.1%) and Neisseriae (13.2%) were most common isolates for Gram-negative organisms. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 2 infants whose symptoms resolved by a routine probing. No difference of bacteriology pattern was detected between patients under 6 months old and those beyond. The pathogens were highly sensitive to chloramphenicol (88%) and levofloxacin (84%), but resistant to erythromycin (40%) and sulfamethoxazole (32%). Conclusions Infants with CNLDO under 1 year of age presented predominance of Streptococcus as Gram-positive organism, and Haemophilus as Gram-negative organism. Levofloxacin was an active topical antibiotic agent with few chance of resistance. These findings could help clinicians choose optimal medicine for CNLDO as the conservative treatments.


2020 ◽  
Author(s):  
Xiaoyu Zheng ◽  
Bonnie Nga Kwan Choy ◽  
Mingming Zhou ◽  
Caiping Shi ◽  
Zhengyan Zhao

Abstract Background: Congenital nasolacrimal duct obstruction (CNLDO) is one of the main causes of epiphora in infants, and antibiotics are usually used as a conservative therapy in the first year. Yet, little is known about the bacteriology of the occluded lacrimal drainage system in this group of patients. The aim of this study was to evaluate the microbiology of lacrimal sac (LS) in Chinese children with CNLDO in their first year of life.Methods: Patients with CNLDO between May 1, 2017 and August 31, 2018 at a tertiary care children’s hospital were enrolled. The study recruited infants who received lacrimal probing under 1 year old, and refluxed discharge from LS was collected. Samples were cultured and susceptibility test was performed for positive culture.Results: Thirty-two patients with CNLDO were included. The ratio of male to female was 23:9. The mean age was 6.7 ± 2.4 (1.7-12) months. Positive cultures was identified in 87.5% of the sample, and presented 38 strains of bacteria. Mixed infection was identified in 10 (31.3%) children. Gram-positive bacteria accounted for 60.5% of all the strains, with Streptococcus (50%) being the most frequent species, whereas Haemophilus (21.1%) and Neisseriae (13.2%) were most common isolates for Gram-negative organisms. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 2 infants whose symptoms resolved by a routine probing. No difference of bacteriology pattern was detected between patients under 6 months old and those beyond. The pathogens were highly sensitive to chloramphenicol (88%) and levofloxacin (84%), but resistant to erythromycin (40%) and sulfamethoxazole (32%).Conclusions: Infants with CNLDO under 1 year of age presented predominance of Streptococcus as Gram-positive organism, and Haemophilus as Gram-negative organism. Levofloxacin was an active topical antibiotic agent with few chance of resistance especially for Chinese children. These findings could help clinicians choose optimal medicine for CNLDO as the conservative treatments.


2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Masabumi Kubo ◽  
Tomoki Sakuraba ◽  
Ryuichi Wada

Purpose. The purpose of this study is to elucidate the clinicopathological features of dacryolithiasis and prevalence of associated infection in Japanese patients. Materials and Methods. Out of 13,471 outclinic patients from 2006 to 2011, 268 patients were scheduled to be performed dacryocystorhinostomy (DCR) due to dacryocystitis with nasolacrimal duct obstruction. Actually 266 patients underwent dacryocystorhinostomy (DCR) and two patients were cured by only ophthalmic examination. Dacryoliths were found in 17 cases (6.3%). Among 17 cases of dacryolithiasis, three patients were male, and 14 were female. The age of the patients ranged from 32 to 82 (mean 67) years, and 13 cases (76%) were more than 65 years of age. Pathological examination disclosed the infectious agents in 9 cases (53%), and all patients with infection were more than 65 years of age. Special stains revealed colonies of fungus, suspicious of Aspergillus, in 6 cases and gram-positive rods, and suspicious of Actinomyces, in 3 cases. Conclusions. The current study showed the frequent association of infection with dacryolithiasis in aged Japanese patients. This should be taken into the consideration for the treatment of dacryolithiasis.


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