Yasmeen Shah Kazmi, Rashid Rehan Syed, Amtul Hafiz.
Role of Staphylococci in Bacterial Dacryocystitis and its Sensitivity Pattern.
J Coll Physicians Surg Pak Nov ;10(6):213-16.

Lacrimal sac swabs were collected from one hundred cases of dacryocystitis who underwent dacryocystectomy or dacryocystorhinostomy at Jinnah Postgraduate Medical center (JPMC), Karachi and fifty normal cases for isolation of Staphylococci from September, 1997 to December, 1998. Bacteria were isolated from 83% cases of dacryocystitis and 56% of normal cases. Coagulase positive Staph aureus was isolated from 41 (40%) cases of dacryocystitis and 5(8%) normal cases. Among Coagulase-Negative Staphylococci(CoNS), Staph eipdermidis and Staph saprophyticus were isolated from 21(20%) and 2(2%) cases of dacryocystitis whereas in normal lacrimal sac these bacteria were isolated from 28(43%) and 14(21%) cases. Isolates of S aureus were resistant to commonly used antibiotics i.e., ampicillin, tetracycline and methicillin but sensitive to kanamycin (90%), vancomycin (80%) and gentamycin (78%), among CONS staph epidermidis were sensitive to gentamycin (90%), vancomycin (85%) and kanamycin (82%) whereas, Staph saprophyticus were resistant to all the antibiotics except vancomycin (100%) and gentamycin (50%) in case of dacryocystitis. All the isolates of Staphylococci from normal lacrimal sac were most sensitive to kanamycin followed by vancomycin and other antibiotics tested. Probing and syringing may open the initial obstructed duct. We emphasize that the antibiotic therapy should be initiated on receipt of culture sensitivity report from a Microbiological laboratory that will not only help in acute cases to resolve inflammation without further fibrosis but also play a significant role in preventing re-infection after dacryocystectomy and will not obstruct newly formed anastomatic opening after dacryocystorhinostomy.

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