Lacrimal sac bacteriology and susceptibility pattern in infants with congenital nasolacrimal duct obstruction in the 1st year of life: a cross-sectional study
Abstract Background Congenital nasolacrimal duct obstruction (CNLDO) is one of the main causes of epiphora in infants, and antibiotics are usually used as a conservative therapy in the first year. Yet, little is known about the bacteriology of the occluded lacrimal drainage system in this group of p...
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | BMC Pediatrics |
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| Online Access: | http://link.springer.com/article/10.1186/s12887-020-02358-5 |
| _version_ | 1819228185505562624 |
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| author | Xiao-Yu Zheng Bonnie Nga Kwan Choy Ming-Ming Zhou Cai-Ping Shi Zheng-Yan Zhao |
| author_facet | Xiao-Yu Zheng Bonnie Nga Kwan Choy Ming-Ming Zhou Cai-Ping Shi Zheng-Yan Zhao |
| author_sort | Xiao-Yu Zheng |
| collection | DOAJ |
| description | Abstract Background Congenital nasolacrimal duct obstruction (CNLDO) is one of the main causes of epiphora in infants, and antibiotics are usually used as a conservative therapy in the first year. Yet, little is known about the bacteriology of the occluded lacrimal drainage system in this group of patients. The aim of this study was to evaluate the microbiology of lacrimal sac (LS) in Chinese children with CNLDO in their first year of life. Methods Patients with CNLDO between May 1, 2017 and August 31, 2018 at a tertiary care children’s hospital were enrolled. The study recruited infants who received lacrimal probing under 1 year old, and refluxed discharge from LS was collected. Samples were cultured and susceptibility test was performed for positive culture. Results Thirty-two patients with CNLDO were included. The ratio of male to female was 23:9. The mean age was 6.7 ± 2.4 (1.7–12) months. Positive cultures was identified in 87.5% of the sample, and presented 38 strains of bacteria. Mixed infection was identified in 10 (31.3%) children. Gram-positive bacteria accounted for 60.5% of all the strains, with Streptococcus (50%) being the most frequent species, whereas Haemophilus (21.1%) and Neisseriae (13.2%) were most common isolates for Gram-negative organisms. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 2 infants whose symptoms resolved by a routine probing. No difference of bacteriology pattern was detected between patients under 6 months old and those beyond. The pathogens were highly sensitive to chloramphenicol (88%) and levofloxacin (84%), but resistant to erythromycin (40%) and sulfamethoxazole (32%). Conclusions Infants with CNLDO under 1 year of age presented predominance of Streptococcus as Gram-positive organism, and Haemophilus as Gram-negative organism. Levofloxacin was an active topical antibiotic agent with few chance of resistance especially for Chinese children. These findings could help clinicians choose optimal medicine for CNLDO as the conservative treatments. |
| first_indexed | 2024-12-23T10:53:16Z |
| format | Article |
| id | doaj.art-47d6f4765efb42d298386af1c32367e9 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-23T10:53:16Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-47d6f4765efb42d298386af1c32367e92022-12-21T17:49:50ZengBMCBMC Pediatrics1471-24312020-10-012011910.1186/s12887-020-02358-5Lacrimal sac bacteriology and susceptibility pattern in infants with congenital nasolacrimal duct obstruction in the 1st year of life: a cross-sectional studyXiao-Yu Zheng0Bonnie Nga Kwan Choy1Ming-Ming Zhou2Cai-Ping Shi3Zheng-Yan Zhao4Department of Ophthalmology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthDepartment of Ophthalmology, LKS Faculty of Medicine, The University of Hong KongDepartment of Clinical Lab, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthDepartment of Ophthalmology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthDepartment of Child Health Care, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthAbstract Background Congenital nasolacrimal duct obstruction (CNLDO) is one of the main causes of epiphora in infants, and antibiotics are usually used as a conservative therapy in the first year. Yet, little is known about the bacteriology of the occluded lacrimal drainage system in this group of patients. The aim of this study was to evaluate the microbiology of lacrimal sac (LS) in Chinese children with CNLDO in their first year of life. Methods Patients with CNLDO between May 1, 2017 and August 31, 2018 at a tertiary care children’s hospital were enrolled. The study recruited infants who received lacrimal probing under 1 year old, and refluxed discharge from LS was collected. Samples were cultured and susceptibility test was performed for positive culture. Results Thirty-two patients with CNLDO were included. The ratio of male to female was 23:9. The mean age was 6.7 ± 2.4 (1.7–12) months. Positive cultures was identified in 87.5% of the sample, and presented 38 strains of bacteria. Mixed infection was identified in 10 (31.3%) children. Gram-positive bacteria accounted for 60.5% of all the strains, with Streptococcus (50%) being the most frequent species, whereas Haemophilus (21.1%) and Neisseriae (13.2%) were most common isolates for Gram-negative organisms. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 2 infants whose symptoms resolved by a routine probing. No difference of bacteriology pattern was detected between patients under 6 months old and those beyond. The pathogens were highly sensitive to chloramphenicol (88%) and levofloxacin (84%), but resistant to erythromycin (40%) and sulfamethoxazole (32%). Conclusions Infants with CNLDO under 1 year of age presented predominance of Streptococcus as Gram-positive organism, and Haemophilus as Gram-negative organism. Levofloxacin was an active topical antibiotic agent with few chance of resistance especially for Chinese children. These findings could help clinicians choose optimal medicine for CNLDO as the conservative treatments.http://link.springer.com/article/10.1186/s12887-020-02358-5Congenital nasolacrimal duct obstructionInfantMicrobiologyLacrimal sacLevofloxacin |
| spellingShingle | Xiao-Yu Zheng Bonnie Nga Kwan Choy Ming-Ming Zhou Cai-Ping Shi Zheng-Yan Zhao Lacrimal sac bacteriology and susceptibility pattern in infants with congenital nasolacrimal duct obstruction in the 1st year of life: a cross-sectional study BMC Pediatrics Congenital nasolacrimal duct obstruction Infant Microbiology Lacrimal sac Levofloxacin |
| title | Lacrimal sac bacteriology and susceptibility pattern in infants with congenital nasolacrimal duct obstruction in the 1st year of life: a cross-sectional study |
| title_full | Lacrimal sac bacteriology and susceptibility pattern in infants with congenital nasolacrimal duct obstruction in the 1st year of life: a cross-sectional study |
| title_fullStr | Lacrimal sac bacteriology and susceptibility pattern in infants with congenital nasolacrimal duct obstruction in the 1st year of life: a cross-sectional study |
| title_full_unstemmed | Lacrimal sac bacteriology and susceptibility pattern in infants with congenital nasolacrimal duct obstruction in the 1st year of life: a cross-sectional study |
| title_short | Lacrimal sac bacteriology and susceptibility pattern in infants with congenital nasolacrimal duct obstruction in the 1st year of life: a cross-sectional study |
| title_sort | lacrimal sac bacteriology and susceptibility pattern in infants with congenital nasolacrimal duct obstruction in the 1st year of life a cross sectional study |
| topic | Congenital nasolacrimal duct obstruction Infant Microbiology Lacrimal sac Levofloxacin |
| url | http://link.springer.com/article/10.1186/s12887-020-02358-5 |
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