Bacterial profiles and antibiotic susceptibility pattern in patients with chronic dacryocystitis

Yıl 2020, , 217 - 221, 01.03.2020

Nergis Aşgın , Murat Çakmaklıoğulları

https://doi.org/10.28982/josam.699901

Öz

Aim: Dacryocystitis is an infection of the lacrimal apparatus, and without appropriate treatment, it can lead to serious complications such as orbital cellulitis and meningitis. In this study, we aimed to determine the frequency and antibiotic susceptibility of the bacterial pathogens in chronic dacryocystitis.
Methods: This cross-sectional study included 60 patients diagnosed with chronic dacryocystitis in the Ophthalmology department of Karabuk Training and Research Hospital between December 2019 and February 2020. Aerobic culture tests were performed using swab samples obtained from the lacrimal punctum of the patients. Identification and antibiotic susceptibility of isolates were determined using Phoenix-100TM (Becton Dickinson, Sparks, MD, USA) fully automated system.
Results: In total, 43 of 60 (71.7%) of patients were females, and the mean age was 56.78 (12.67) years. Aerobic bacteria were isolated from 51 (85%) of 60 samples. The most common pathogens were Pseudomonas aeruginosa (45%), Staphylococcus epidermidis (15.7%), and Staphylococcus aureus (11.8%) respectively. The most effective antibiotics against Gram-negative bacteria were aminoglycosides with a susceptibility of >90%. Gentamicin was also active against 85.7% of Gram-positive bacteria. Although in-vitro efficacy of ciprofloxacin was 81.5% against Gram-negative bacteria, it was mildly active against Gram-positive bacteria (52.5%). Methicillin resistance was detected in 33% of Staphylococcus species.
Conclusion: In our region, aminoglycosides may be preferred instead of fluoroquinolones for the empirical treatment of chronic dacryocystitis. However, since our study is single-centered and small-sized, these findings should be supported by large-scale studies in the future.

Anahtar Kelimeler

Dacryocystitis, Corynebacterium striatum, Pseudomonas aeruginosa, Antibiotic, Ciprofloxacin, Gentamicin

Teşekkür

Acknowledgment: The authors would like thank to Dr.Ahmet Ekizoglu for data collection and participant support.

Kronik dakriyosistitli hastalarda bakteri profili ve antibiyotik duyarlılık paterni

Öz

Amaç: Dakriyosistit lakrimal aparatusun enfeksiyonu olup, uygun şekilde tedavi edilmezse orbital sellülit, menenjit gibi ciddi komplikasyonlara yol açabilir. Bu çalışmada kronik dakriyosistitte, bakteriyel patojenlerin sıklığını ve antibiyotik duyarlılık profilini saptamayı amaçladık.
Yöntemler: Bu kesitsel çalışmaya Aralık 2019- Şubat 2020 tarihleri arasında Karabük Eğitim ve Araştırma Hastanesi Göz hastalıkları bölümünde kronik dakriyosistit tanısı almış 60 hasta dahil edilmiştir. Hastaların punktumundan alınan sürüntü örneklerinden aerop kültür yapılmıştır. İzolatların identifikasyonu ve antibiyotik duyarlılığı Phoenix-100 (Becton Dickinson,MD, PA,USA) tam otomatize sistemle saptanmıştır.
Bulgular: Kronik dakriyosistitli toplam 60 hastanın 43’ü (%71,7) kadın olup yaş ortalaması 56,78 (12,67) idi. Altmış örneğin 51 inde aerop bakteri üredi (%85). En sık izole edilen patojenler Pseudomonas aeruginosa (%45), Staphylococcus epidermidis (15,7) ve Staphylococcus aureus (%11,8) idi. Gram negatif bakterilere en etkili antibiyotikler aminoglikozidler olup, duyarlılık %90’ın üzerinde idi. Gentamisin, Gram-pozitif bakterilere de %85,7 oranında etkili idi. Siprofloksasinin etkinliği Gram- negatiflerde %81,5 iken, Gram-pozitif bakterilere düşük etkili idi (%52,5). Stafilokok türlerinin %33’ ünde ise metisilin direnci saptandı.
Sonuç: Yöremizde kronik dakriyosistitin ampirik tedavisinde florokinolonlar yerine aminoglikozidler tercih edilebilir. Bununla birlikte, çalışmamız tek merkezli ve küçük boyutlu olduğundan, bu bulgular gelecekte büyük ölçekli çalışmalarla desteklenmelidir. 

Anahtar Kelimeler

Dakriyosistit, Corynebacterium striatum, Pseudomonas aeruginosa, Antibiyotik, Gentamisin, Siprofloksasin

Kaynakça

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