Microbiology and Antimicrobial Susceptibility in Adult Dacryocystitis

Yi-Chun Chi,1,2 Chia-Ching Lin,1,2 Tzu-Yu Chiu1,2 1Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 2Kaohsiung Medical University, Kaohsiung, TaiwanCorrespondence: Tzu-Yu Chiu, Department of Ophthalmology, Kaohsiung Medical University Hospital, Number 100, Tzyou 1st Road, Sanmin District, Kaohsiung City, 807, Taiwan, Tel +886-7-3121101 ext. 6531, Email kathychiu77924@hotmail.comPurpose: To investigate the microbiology and antimicrobial susceptibility of dacryocystitis in adults and identify the changing trends over time in Taiwan.Methods: This is a single-centered, retrospective study. We retrospectively reviewed adult patients with dacryocystitis from January 2012 to December 2021 in a tertiary medical center in Taiwan. The pathogens and in vitro antimicrobial susceptibility of the pus cultures from the lacrimal sac were collected.Results: Thirty-five cultures in acute and 211 cultures in chronic dacryocystitis were collected. Of the 220 isolates, a similar proportion of gram-positive (44%) and gram-negative (43%) aerobes were demonstrated in chronic dacryocystitis and more gram-negative aerobes (50%) than gram-positive aereobes (41%) in acute dacryocystitis. The most common pathogens were methicillin-resistant Staphylococcus aureus (MRSA; 28.1%) and Pseudomonas aeruginosa (28.1%) in acute dacryocystitis, while coagulase-negative Staphylococci was the most common micro-organism in chronic dacryocystitis. The effective antibiotics for gram-positive aerobes were vancomycin (100%), moxifloxacin (88%) and trimethoprim/sulfamethoxazole (78%). Meropenem (95%), amikacin (93%), and levofloxacin (91%) were sensitive to more than 90% of gram-negative aerobes in current study. High resistant species were also isolated in our cohort.Conclusion: More gram-negative pathogens and more resistant species are rising in adult dacryocystitis. Understanding the bacteriology and antimicrobial susceptibility of the region is crucial for the empirical antibiotic selection in clinical practice.Keywords: dacryocystitis, antibiotic, microbiology