title: Spectrum and the susceptibilities of microbial isolates in cases of congenital nasolacrimal duct obstruction.
abstract: OBJECTIVE
  To determine the microbial profile of congenital nasolacrimal duct obstruction (CNLDO) and the appropriate antimicrobial agents based on the sensitivity pattern of the isolated microorganisms.
  
  
  METHODS
  Two hundred thirty-eight eyes of 187 young children in the age group of 0-5 years with CNLDO were included in the study. A group of 40 children (80 eyes) who had attended the hospital for other ocular disorders was considered a control. Material obtained from the lacrimal sac was cultured, and infectious agents were isolated. Susceptibility testing was done by Kirby-Bauer disk diffusion method for 7 different antibiotics. Fisher's exact test was used to look for statistical associations between the age group, the type of discharge, and the type of microorganisms isolated.
  
  
  RESULTS
  Of the 238 samples with a clinical diagnosis of CNLDO, 197 (83%) yielded a positive culture. There was no growth in 41 samples (17%). Altogether, there were 217 isolates. One hundred twenty-four (57%) isolates were Gram-positive bacteria, the most frequent isolate being Streptococcus pneumoniae. Gram-negative bacteria accounted for 93 (43%) of the isolates, the most frequent isolate being Haemophilus influenza. There was one fungal isolate (0.5%) of Candida tropicalis. Gram-positive bacteria were sensitive to chloramphenicol, vancomycin, and ofloxacin and Gram-negative bacteria to ofloxacin and ciprofloxacin.
  
  
  CONCLUSIONS
  Chronic dacryocystitis caused by CNLDO is associated with an almost-equal proportion of Gram-positive and Gram-negative bacteria. Ofloxacin topical drops can be used in the treatment of cases with CNLDO.
authors.affiliation: Department of Orbit and Oculoplasty, Aravind Eye Hospital & PG Institute of Ophthalmology, Madurai, India. usha@aravind.org
authors.forename: Kim
authors.initials: K
authors.lastname: Usha
authors.forename: Sankaranarayanan
authors.initials: S
authors.lastname: Smitha
authors.forename: Nagendra
authors.initials: N
authors.lastname: Shah
authors.forename: Prajna
authors.initials: P
authors.lastname: Lalitha
authors.forename: Rahul
authors.initials: R
authors.lastname: Kelkar
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D001431:Bacteriological Techniques; D002675:Child, Preschool; D003607:Dacryocystitis / Q000151:congenital / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000382:microbiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007767:Lacrimal Duct Obstruction / Q000151:congenital* / Q000382:microbiology*; D008297:Male; D008826:Microbial Sensitivity Tests; D009301:Nasolacrimal Duct / Q000382:microbiology*; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents