Bacteriology of Adult Chronic Dacryocystitis Cases in Rajshahi Medical College Hospital

Abstract

Background: A large number of people in Bangladesh suffer from chronic dacryocystitis. This is the 2nd highest eye problem among hospitalized patients after cataract. Although the final treatment option is surgery, it is essential to give antibiotics as conservative treatment before going into operative procedure. Otherwise, the chances of soft tissue infections are up to five times higher. Objective: The aim of this study was to know the bacteriological spectrum as well as their antibiotic susceptibility pattern to obtain the appropriate therapeutic response. Methods: A cross sectional type of descriptive study was carried out in the eye ward of RMCH between January to December 2017. One hundred diagnosed cases of chronic dacryocystitis undergoing DCR operation were selected and lacrimal sac swabs were collected from each patient. Isolation and identification of bacteria and their antibiotic sensitivity test were done by standard procedure in the laboratory of Microbiology Department, RMC. Results: Out of 100 swabs, 73(73%) were found culture positive among which Gram+ve organisms were 53 (72.58%) and Gram-ve were 20(27.42%). S.epidermidis was the predominant Gram+ve (39.73%) organism followed by S.aureus (30.12%) and S.pyogenes (2.74%). P.aeruginosa was the predominant Gram-ve isolate. The least isolated (2.74%) organism was St.pyogenes. In the Gram+ve isolates, vancomycin was the most sensitive drug (100%) followed by oxacillin (98.11%), chloramphenicol (94.33%), tetracycline (92.5%). and cefipime (92.5%) where as non of the antibiotics were satisfactorily sensitive against Gram-ve isolates. Conclusion: Culture and sensitivity test before prescribing antibiotics in case of chronic dacryocystitis should be an early treatment option or before doing surgery. It is beneficial both for the patient and ophthalmologist and will also prevent the emergence of drug
resistant bacterial strains.