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Study of the current pattern of bacterial isolates with nasolacrimal passage obstruction and their antibiotic sensitivity patterns in a teaching hospital

Nilay Dhore, Shashi Prabha Prasad, Karishma Tendulkar, Amod Ahuja, Mayur Patil, Kunj Naik, Tanmoy Vaidya, Rishikesh Pawar.




Abstract
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Introduction: An acquired nasolacrimal duct obstruction can occur at any age and is classified as either primary or secondary. The nasolacrimal obstruction occurring primarily, also known as PANDO (Primary acquired nasolacrimal duct obstruction), is observed mainly in conditions occurring due to inflammation or fibrosis.
Material and methods: This prospective observational study with a sample size of 100 patients. All the patients coming to Ophthalmology OPD complained of epiphora, discharge or both, along with regurgitation on pressure over lacrimal sac and mucoid or mucopurulent or clear regurgitant material on sac stringing, were taken. Before the beginning of the investigative procedure, informed consent was taken. The Clinical and Laboratory Standards Institute's standardised Kirby-Bauer disc diffusion test was used to determine antibiotic susceptibility.
Results: In our study, the distribution of patients according to bacterial isolates was as follows, a maximum of 62% of patients were found with no growth while 18% MSSA, 10% CONS, 6% S.pneumoniae, 4% Pseudomonas were observed, respectively. In our study, CONS was observed as the predominant bacterial isolate in the diabetics with a Female preponderance, followed by MSSA (39%), Pseudomonas (75%) and S.pneumoniae (34%). We found Ciprofloxacin as a broad-spectrum antibiotic that works against most bacterial isolates.
Conclusion: A higher female preponderance was observed in our study, with the left side being affected in most of the patients. We also observed that most patients hailed from rural areas and belonged to lower socio-economic classes. This is attributed to poor hygiene and awareness among low socioeconomic groups. Gram-positive organisms were the dominant species in all patients showing positive culture growth. We conclude that Ciprofloxacin, as a broad-spectrum antibiotic, works against most bacterial isolates.

Key words: Nasolacrimal passage, bacterial isolates






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