title: Bacteremia Following Nasolacrimal Duct Probing: Is There a Role of Preoperative Antibiotic Prophylaxis?
abstract: OBJECTIVE
  To study the incidence of nasolacrimal duct probing-induced bacteremia using the metabolic colorimetric sensor technique of blood culture.
  
  
  METHODS
  Prospective, interventional study of all consecutive patients who underwent endoscopic-guided probing for congenital nasolacrimal duct obstruction (CNLDO). All patients were operated by a single surgeon (MJA). Blood was drawn under strict aseptic conditions before and after probing. Blood culture was performed using the BacT/ALERT microbial detection system and the protocols were followed as per the manufacturer and Clinical and Laboratory Standard Institute guidelines. Probing induced bacteremia was defined as a negative pre-probing culture and a positive post-probing culture.
  
  
  RESULTS
  Thirty-one eyes of 25 consecutive patients with CNLDO who underwent probing were studied. The mean age at probing was 27 months. All patients presented with epiphora and occasional discharge. One patient presented with unilateral dacryocele along with an acute dacryocystitis. All the pre and post-probing cultures were negative except for the one with acute dacryocystitis. The subsequent subcultures and identification by VITEK 2 system revealed the bacteremia to be caused by Haemophilus influenzae.
  
  
  CONCLUSIONS
  Nasolacrimal duct probing does not induce bacteremia in routine CNLDO cases unless there is an associated acute dacryocystitis. Preoperative antibiotic prophylaxis is perhaps not needed for systemically healthy CNLDO patients without an acute dacryocystitis. However, with regards to infantile acute dacryocystitis, further evidence is needed to formulate guidelines on additional preoperative antibiotic prophylaxis other than the routine treatment of infection.
authors: *Dacryology Service, L.V. Prasad Eye Institute, Hyderabad, India; †Jhaveri Microbiology Center, L.V. Prasad Eye Institute, Hyderabad, India; and ‡Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, India.
authors: Anasua
authors: A
authors: Ganguly
authors: Mohammad Javed
authors: MJ
authors: Ali
authors: Kanne
authors: K
authors: Padmaja
authors: Savitri
authors: S
authors: Sharma
authors: Vemu
authors: V
authors: Lakshmi
authors: Milind N
authors: MN
authors: Naik
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D001431:Bacteriological Techniques; D002648:Child; D002675:Child, Preschool; D003608:Dacryocystorhinostomy / Q000009:adverse effects*; D015818:Eye Infections, Bacterial / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D005260:Female; D006192:Haemophilus Infections / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007223:Infant; D007765:Lacrimal Apparatus; D007767:Lacrimal Duct Obstruction / Q000151:congenital / Q000628:therapy; D008297:Male; D011300:Preoperative Care; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents