Flora bakteryjna woreczka łzowego i jamy nosowej u pacjentów z nabytą niedrożnością przewodu nosowo-łzowego operowanych metodą endoskopowej dacryocystorhinostomii
Bacterial Flora of the Lacrimal Sac and the Nose in Patients with Acquired Nasolacrimal Duct Obstruction Undergoing Endoscopic Dacryocystorhinostomy
Iwona Obuchowska1, Andrzej Sieśkiewicz2, Zofia Mariak1, Marek Rogowski2
1Klinika Okulistyki Uniwersytetu Medycznego w
Kierownik: prof. dr hab. n. med. Zofia Mariak
2Klinika Otolaryngologii Uniwersytetu Medycznego w Białymstoku
Kierownik: prof. dr hab. n. med. Marek Rogowski
Summary: Purpose: In patients with lacrimal drainage system obstruction, the inflammation and fibrosis may be secondary to coexisting infectious colonization within the lacrimal sac. It is possible that many cases of acquired nasolacrimal duct obstruction are in fact secondary to unrecognized low-grade dacryocystitis. The intent of this study was to determine what organism grow in the lacrimal sac of patients required dacrocystorhinostomy (DCR). It also investigated correlation between organism cultured from the lacrimal sac and the nose. Material and Methods: The study included 20 patients (16 women and 4 men) with unilateral epiphora undergoing endoscopic DCR. Samples were obtained intraoperatively from the lacrimal sac near the sac-duct junction and from the nose. Microbiologic analysis was carried out to determine the presence and identification of organisms. Results: Positive culture results from lacrimal sac were obtained in 80%. The majority of microorganisms in our study were Gramm-positive bacteria, accounting for 87.5% the overall isolates with a predominance of Staphylococcus aureus (56.2%) and Staphylococcus epidermidis (25%). Gramm-negative bacteria were present in 18.7% of the specimens. In 45% of patients the same microorganisms were cultured from the two studied sites. Conclusion: The presence of a positive culture results is independent of a history of dacryocystitis. Nasolacrimal duct obstruction in adults is associated with an increased proportion of Gramm-negative organisms in rate to physiological bacterial flora. There is not a clinically significant correlation between bacterial flora of the lacrimal sac and the nose.
Keywords: dacryocystorhinostomia, lacrimal sac, nose, bacterial flora.