title: Bacteremia during dacryocystorhinostomy: results of intra-operative blood cultures.
abstract: BACKGROUND
  The aims of the study are to assess the prevalence of bacteremia during dacryocystorhinostomy (DCR) and to assess whether there is a need for post-operative prophylaxis. Prospective interventional study of 52 consecutive dacryocystorhinostomy performed in 50 patients over a period of 1 year from 2013 to 2014. Blood was drawn under strict aseptic conditions during two separate time points: fashioning of the nasal mucosal and creation of lacrimal sac flaps. The blood was inoculated into two blood culture bottles: the dual media as well as Columbia broth. Following withdrawal of blood, all patients received an intraoperative single dose of a cephalosporin antibiotic. Clean cases of primary acquired nasolacrimal duct obstructions (PANDO) without any sac discharge upon marsupialization (22%, 11/50) were not prescribed routine post-operative prophylaxis, whereas the remaining were prescribed oral antibiotics for 5 days.
  
  
  RESULTS
  The mean age of patients was 41 years (range, 4-61 years). The most common diagnosis (70%, 35/50) was primary acquired nasolacrimal duct obstruction. Acute dacryocystitis was noted in 12% (6/50). External DCR was performed in 65% (34/52) and endoscopic DCR in 35% (18/52) of the cases. All the blood cultures were uniformly negative both in terms of abnormal physical changes in media as well subcultures; 22% (11/50) did not receive post-operative antibiotic prophylaxis. None of the patients developed any signs of wound infections. The anatomical and functional success rate was achieved in 98%.
  
  
  CONCLUSIONS
  This study did not find any intraoperative bacteremia during dacryocystorhinostomy and that none had wound infection irrespective of post-operative prophylaxis.
authors.affiliation: Dacryology Service, L.V.Prasad Eye Institute, Hyderabad 34, India.
authors.forename: Mohammad Javed
authors.initials: MJ
authors.lastname: Ali
authors.affiliation: Dacryology Service, L.V.Prasad Eye Institute, Hyderabad 34, India.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Ayyar
authors.affiliation: Jhaveri Microbiology Center, L.V.Prasad Eye Institute, Hyderabad 34, India.
authors.forename: Swapna R
authors.initials: SR
authors.lastname: Motukupally
authors.affiliation: Jhaveri Microbiology Center, L.V.Prasad Eye Institute, Hyderabad 34, India.
authors.forename: Savitri
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Dacryology Service, L.V.Prasad Eye Institute, Hyderabad 34, India.
authors.forename: Milind N
authors.initials: MN
authors.lastname: Naik
keywords: Antibiotics; Bacteremia; Blood culture; Dacryocystorhinostomy