A Prospective Study of Clinical and Microbiological Profile of Dacryocystitis

Background: Dacryocystitis, an inflammatory condition of the lacrimal sac, presents in both acute and chronic forms. Chronic dacryocystitis is more prevalent, accounting for 87.1% of epiphora cases, often causing social discomfort due to persistent eye-watering. Identifying the antibiogram of causative microorganisms is crucial for guiding effective antimicrobial therapy. This study aimed to evaluate the clinical profile and antibiogram of acute and chronic dacryocystitis. Method: This prospective observational study included patients with acute or chronic dacryocystitis attending the ophthalmology outpatient department. Eligible participants were enrolled, and samples were collected for microbiological analysis, including gram staining, culture, and sensitivity testing. Results: A total of 50 cases of acute and chronic dacryocystitis were included in the study. The majority of cases were observed in the >40-50 age group for both acute (25%) and chronic (34.2%) dacryocystitis. Staphylococcus aureus was the most common organism isolated in both acute and chronic cases. Staphylococcus epidermidis was also frequently isolated, particularly in chronic cases. Pseudomonas aeruginosa was the most common gram-negative organism isolated. Staphylococcus aureus showed a high susceptibility to vancomycin and gentamicin. Staphylococcus epidermidis showed a high susceptibility to vancomycin. Streptococcus pneumoniae: was highly susceptible to beta-lactam antibiotics. Pseudomonas aeruginosa: had a high susceptibility to beta-lactam antibiotics, moderate susceptibility to aminoglycosides, and variable susceptibility to fluoroquinolones. Conclusion: The most commonly isolated bacterial pathogen in dacryocystitis in this region was Staphylococcus (Gram-positive), followed by Pseudomonas, Pneumococcus, and Staphylococcus epidermidis. Vancomycin showed the highest efficacy against Gram-positive bacteria, while third-generation cephalosporins, gentamycin, and amikacin were most effective against Gram-negative bacteria.