title: Bacteriological profile in conjunctival, lacrimal sac, and nasal specimens and conjunctival normalization time following external, endoscopic, and transcanalicular multidiode laser dacryocystorhinostomy.
abstract: OBJECTIVE
  To compare the conjunctival, lacrimal sac, and nasal flora cultures and conjunctival normalization time following external (EX-), endoscopic (EN-), and transcanalicular multidiode laser (TC-) dacryocystorhinostomy (DCR) and to evaluate the relationship between culture positivity and surgical success. We further performed antibiotic sensitivity analyses for lacrimal sac culture samples.
  
  
  METHODS
  A total of 90 patients with primary acquired nasolacrimal duct obstruction were recruited and divided into EX-DCR (n=32), EN-DCR (n=28), and TC-DCR (n=30) groups. Conjunctival, nasal, and lacrimal sac cultures and antibiograms were analyzed.
  
  
  RESULTS
  In all three groups, coagulase-negative Staphylococcus (CNS) was predominantly isolated preoperatively from the conjunctiva, nose, and lacrimal sac and postoperatively from the conjunctiva. Preoperative and postoperative conjunctival culture positivity rates were similar between all the groups (p>0.05). A statistically significant difference in the growth rate of culture in the lacrimal sac was observed between the three groups (p=0.001). CNS and Staphylococcus aureus cultures were predominantly sensitive to linezolid, teicoplanin, tigecycline, vancomycin, and mupirocin. Conjunctival normalization times were similar between the three groups (p>0.05). Anatomical and functional success rates were not found to be significantly correlated with preoperative conjunctival and lacrimal sac culture positivity (p>0.05).
  
  
  CONCLUSIONS
  Similar rates of preoperative and 1-week postoperative conjunctival culture positivity were observed in all the groups; a significantly lower bacterial growth rate was observed in postoperative conjunctival cultures. CNS was the most commonly isolated organism. Bacterial growth rates in the lacrimal sac samples were significantly higher in the EN-DCR group. Bacterial growth rates obtained preoperatively from the conjunctival and lacrimal sac culture samples were not correlated with DCR success.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey.|Department of Ophthalmology, Bagcilar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Melike
authors.initials: M
authors.lastname: Balikoglu-Yilmaz
authors.affiliation: Department of Microbiology and Clinical Microbiology Bagcilar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Ayse Banu
authors.initials: AB
authors.lastname: Esen
authors.affiliation: Department of Ophthalmology, Bagcilar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Yilmaz
authors.affiliation: Department of Otorhinolaryngology, Bagcilar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Taskin
authors.affiliation: Department of Ophthalmology, Bagcilar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Muhittin
authors.initials: M
authors.lastname: Taskapili
authors.affiliation: Department of Otorhinolaryngology, Bagcilar Education and Research Hospital, Istanbul, Turkey.
authors.forename: M Faruk
authors.initials: MF
authors.lastname: Oktay
authors.affiliation: Department of Ophthalmology, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Sen
authors.affiliation: Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, Izmir, Turkey.
authors.forename: Timur
authors.initials: T
authors.lastname: Kose
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001419:Bacteria / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D003228:Conjunctiva / Q000382:microbiology*; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000382:microbiology*; D007767:Lacrimal Duct Obstruction / Q000382:microbiology; D054023:Lasers, Semiconductor / Q000627:therapeutic use; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000382:microbiology* / Q000601:surgery*; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D009666:Nose / Q000382:microbiology; D011446:Prospective Studies; D012016:Reference Values; D013210:Staphylococcus / Q000302:isolation & purification; D018709:Statistics, Nonparametric; D055815:Young Adult