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Article: Lacrimal sac bacteriology and susceptibility pattern in infants with congenital nasolacrimal duct obstruction in the 1st year of life: a cross-sectional study
Title | Lacrimal sac bacteriology and susceptibility pattern in infants with congenital nasolacrimal duct obstruction in the 1st year of life: a cross-sectional study |
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Authors | |
Keywords | Congenital nasolacrimal duct obstruction Infant Microbiology Lacrimal sac Levofloxacin |
Issue Date | 2020 |
Publisher | BioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcpediatr/ |
Citation | BMC Pediatrics, 2020, v. 20 n. 1, p. article no. 465 How to Cite? |
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. |
Persistent Identifier | http://hdl.handle.net/10722/293207 |
ISSN | 2023 Impact Factor: 2.0 2023 SCImago Journal Rankings: 0.688 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Zheng, XY | - |
dc.contributor.author | Choy, BNK | - |
dc.contributor.author | Zhou, MM | - |
dc.contributor.author | Shi, CP | - |
dc.contributor.author | Zhao, ZY | - |
dc.date.accessioned | 2020-11-23T08:13:22Z | - |
dc.date.available | 2020-11-23T08:13:22Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | BMC Pediatrics, 2020, v. 20 n. 1, p. article no. 465 | - |
dc.identifier.issn | 1471-2431 | - |
dc.identifier.uri | http://hdl.handle.net/10722/293207 | - |
dc.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. | - |
dc.language | eng | - |
dc.publisher | BioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcpediatr/ | - |
dc.relation.ispartof | BMC Pediatrics | - |
dc.rights | BMC Pediatrics. Copyright © BioMed Central Ltd. | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Congenital nasolacrimal duct obstruction | - |
dc.subject | Infant | - |
dc.subject | Microbiology | - |
dc.subject | Lacrimal sac | - |
dc.subject | Levofloxacin | - |
dc.title | Lacrimal sac bacteriology and susceptibility pattern in infants with congenital nasolacrimal duct obstruction in the 1st year of life: a cross-sectional study | - |
dc.type | Article | - |
dc.identifier.email | Choy, BNK: bnkchoy@hku.hk | - |
dc.identifier.authority | Choy, BNK=rp01795 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1186/s12887-020-02358-5 | - |
dc.identifier.pmid | 33023519 | - |
dc.identifier.pmcid | PMC7539386 | - |
dc.identifier.scopus | eid_2-s2.0-85092459031 | - |
dc.identifier.hkuros | 320162 | - |
dc.identifier.volume | 20 | - |
dc.identifier.issue | 1 | - |
dc.identifier.spage | article no. 465 | - |
dc.identifier.epage | article no. 465 | - |
dc.identifier.isi | WOS:000578260900001 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 1471-2431 | - |