scholarly journals Lacrimal Sac Bacteriology and Susceptibility Pattern in Infants with Congenital Nasolacrimal Duct Obstruction in the 1st Year of Life: A Cross-Sectional Study

2020 ◽  
Author(s):  
Xiaoyu Zheng ◽  
Bonnie Nga Kwan Choy ◽  
Mingming Zhou ◽  
Caiping Shi ◽  
Zhengyan Zhao
Keyword(s):  
Tertiary Care ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
First Year ◽  
Lacrimal Sac ◽  
Gram Positive ◽  
Cross Sectional ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Gram Negative ◽  
Duct Obstruction

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 1.5 : 1. The mean age was 6.6 ± 2.3 (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 (35.7%) 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. These findings could help clinicians choose optimal medicine for CNLDO as the conservative treatments.

scholarly journals Lacrimal Sac Bacteriology and Susceptibility Pattern in Infants with Congenital Nasolacrimal Duct Obstruction in the 1st Year of Life: A Cross-Sectional Study

2020 ◽  
Author(s):  
Xiaoyu Zheng ◽  
Bonnie Nga Kwan Choy ◽  
Mingming Zhou ◽  
Caiping Shi ◽  
Zhengyan Zhao
Keyword(s):  
Tertiary Care ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Chinese Children ◽  
First Year ◽  
Lacrimal Sac ◽  
Gram Positive ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Gram Negative ◽  
Duct Obstruction

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.

scholarly journals Lacrimal sac bacteriology and susceptibility pattern in infants with congenital nasolacrimal duct obstruction in the 1st year of life: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiao-Yu Zheng ◽  
Bonnie Nga Kwan Choy ◽  
Ming-Ming Zhou ◽  
Cai-Ping Shi ◽  
Zheng-Yan Zhao
Keyword(s):  
Tertiary Care ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Chinese Children ◽  
First Year ◽  
Lacrimal Sac ◽  
Gram Positive ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Gram Negative ◽  
Duct Obstruction

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.

scholarly journals Lacrimal Sac Bacteriology and Susceptibility Pattern in Infants with Congenital Nasolacrimal Duct Obstruction in the 1st Year of Life: A Cross-Sectional Study 

2020 ◽  
Author(s):  
Xiaoyu Zheng ◽  
Bonnie Nga Kwan Choy ◽  
Mingming Zhou ◽  
Caiping Shi ◽  
Zhengyan Zhao
Keyword(s):  
Tertiary Care ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Chinese Children ◽  
First Year ◽  
Lacrimal Sac ◽  
Gram Positive ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Gram Negative ◽  
Duct Obstruction

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.

scholarly journals MICROBIOLOGICAL PROFILE IN PATIENTS WITH CONGENITAL NASO LACRIMAL DUCT OBSTRUCTION

2020 ◽  
pp. 1-4
Author(s):  
N. V. N Prasanna Bharathi ◽  
P. Ramdas ◽  
M. Padma ◽  
Sowmya Andole
Keyword(s):  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Gram Positive ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Gram Negative ◽  
Duct Obstruction ◽  
Gram Positive Bacteria ◽  
Silicon Tube ◽  
Mixed Bacteria ◽  
A Prospective Study

AIM: To study and evaluate the different organisms that are responsible for congenital nasolacrimal duct obstruction .To initiate appropriate antimicrobials based on the sensitivity patterns of the isolated organisms. Methods: It is a prospective study conducted in Sarojini Devi Eye hospital during September 2016 to February 2018. 112 samples from 100 cases were collected from clinically diagnosed congenital nasolacrimal duct obstruction with epiphora below 1 year without any ocular and systemic diseases .Swabs taken were analysed for causative microorganisms of congenital nasolacrimal duct obstruction. Results: In our study out of 112 samples[88 unilateral cases+12 bilateral cases ]82 cases [73.21%] were culture positive, of which80 [71.42%]were bacterial,2 cases [1.78%]were mixed [ bacterial +fungal].Gram positive bacteria were predominant, staphylococcus epidermidis 56[68.29%] followed by Staphylococcus aureus 13[15.85%].Among gram negative bacteria Escherichia coli 1 [1.21%], klebsiella 1[1.21%]. 2 cases were mixed [bacteria +fungal]. Infection is more commonly seen in right eye. Rate of infection was higher in females 62[55.35].Higher incidence of infection was seen in the age group of less than 7 months. Both gram positive and gram negative were most susceptible to tobramycin. Conclusion: Among all the congenital nasolacrimal duct obstructions 90% of the cases would resolve spontaneously with medical therapy and Criggler massage. 10 % of the cases require probing and silicon tube intubation. The knowledge of identification , awareness and bacteriology of congenital nasolacrimal duct obstruction by the paediatricians , physicians and the parents would contribute to the choice of effective antimicrobials and reduce keratitis medicamentosa ,induced astigmatism due to excessive eye rubbing and apprehension among the parents.

Functional metagenomic profile of the lacrimal sac microbial communities in primary acquired nasolacrimal duct obstruction: The Lacriome paper 2

2021 ◽  
pp. 112067212110640
Author(s):  
Mohammad Javed Ali
Keyword(s):  
Functional Analysis ◽  
Microbial Communities ◽  
Cell Structure ◽  
Tertiary Care ◽  
Nasolacrimal Duct ◽  
Ecosystem Dynamics ◽  
Nasolacrimal Duct Obstruction ◽  
Lacrimal Sac ◽  
Duct Obstruction ◽  
Information Processes

Purpose To study the functional metagenomic profile of the microbes isolated from the lacrimal sac of patients with primary acquired nasolacrimal duct obstruction. Methods A prospective study was performed on 10 consecutive lacrimal sac samples obtained for the metagenomic analysis from patients with primary acquired nasolacrimal duct obstruction ( who underwent endoscopic dacryocystorhinostomy at a tertiary care Dacryology service. The samples were collected intraoperatively soon after a full-length lacrimal sac marsupialization and immediately transported on ice to the laboratory. Following DNA extraction and library preparation, a whole shotgun metagenome sequencing was performed on the Illumina NOVASEQ 6000TM platform. The downstream processing and bioinformatics of the samples were performed using multiple software packaged in SqueezeMetaTM pipeline and functional analysis using the MG-RASTTM pipeline. Results The microbial gene mapping and protein prediction demonstrated proteins with known functions to range from 66.41% to 84.03% across the samples. The functional category distribution of Kyoto Encyclopedia of Genes and Genomes ortholog (level 1 data) showed metabolism to be the most commonly involved function followed by environmental information processes, genetic information processes and cellular processes. The functional subsystem profiling demonstrated genes associated with carbohydrate, protein and RNA metabolism, Amino acids and their derivatives, cofactors and prosthetic groups and factors involved in cell structure regulation and cell cycle control. Conclusion This is the first functional metagenomic profile of the lacrimal sac microbiota from patients with primary acquired nasolacrimal duct obstruction. Functional analysis has provided newer insights into the ecosystem dynamics and strategies of microbial communities inhabiting the lacrimal sac. Further Lacriome studies may provide clues for better understanding of the disease etiopathogenesis.

Metagenomics of the lacrimal sac in primary acquired nasolacrimal duct obstruction: the Lacriome paper 1

2021 ◽  
pp. bjophthalmol-2021-319677
Author(s):  
Mohammad Javed Ali
Keyword(s):  
Tertiary Care ◽  
Alpha Diversity ◽  
Downstream Processing ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Lacrimal Sac ◽  
Illumina Platform ◽  
Duct Obstruction ◽  
Cutibacterium Acnes ◽  
Metagenome Sequencing

BackgroundThe purpose is to study the metagenomics of the microbes isolated from the lacrimal sac of patients with primary acquired nasolacrimal duct obstruction (PANDO).MethodsA prospective study was performed on ten consecutive lacrimal sac samples obtained for the metagenomic analysis from the patients with PANDO, who underwent endoscopic dacryocystorhinostomy at a tertiary care Dacryology service. The samples were collected intraoperatively soon after a full-length lacrimal sac marsupialisation and immediately transported on ice to the laboratory. Following DNA extraction and library preparation, a whole shotgun metagenome sequencing was performed on the Illumina platform. The downstream processing and bioinformatics of the samples were performed using multiple software packaged in the SqueezeMeta pipeline and MG-RAST pipeline.ResultsThe taxonomic hit distribution across the samples showed that bacteria were the most common isolates (mean—97.56%), followed by viruses (mean—0.29%), archaea (0.04%) and others. The five major phyla identified across the samples of PANDO were proteobacteria, Bacteroidetes, Fusobacteria, Actinobacteria and Firmicutes. The prevalent organisms include Acinetobacter johnsonii, Porphyromonas catoniae, Cutibacterium acnes, Pseudomonas alcaliphila, Escherichia coli, Haemophilus influenzae, Enhydrobacter aerosaccus, Fusobacterium nucleatum, Moraxella osloensis, Butyricimonas virosa and Variovorax paradoxus, among few others. The alpha diversity of the ten sample datasets ranged from 60 to 175 species.ConclusionThis is the first whole metagenome sequencing of the lacrimal sac contents from PANDO patients. Lacrimal sacs harbour diverse microbial communities, including bacteria, viruses, and archaea. Further Lacriome studies may provide clues for a better understanding of the disease aetiopathogenesis.

scholarly journals Outcome of probing and syringing in congenital nasolacrimal duct obstruction at various age groups in a tertiary eye center in Western Nepal

2018 ◽  
Vol 9 (6) ◽  
pp. 57-61
Author(s):  
Koshal Shrestha ◽  
Binita Bhattarai ◽  
Laxmi Devi Manandhar ◽  
Salma KC Rai ◽  
Arniko Pandey ◽  
...  
Keyword(s):  
Invasive Procedure ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Successful Outcome ◽  
Optimal Time ◽  
Cross Sectional ◽  
Female Ratio ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Primary Treatment Modality

Background: Congenital nasolacrimal duct obstruction (CNLDO) is one of the commonest problems encountered in daily ophthalmology practice. Though probing and syringing is the mainstay of management of CNLDO, there is no clear guideline about the optimal time to perform.Aims and Objective: To evaluate the efficacy of probing and syringing in cases of congenital nasolacrimal duct obstruction in various age groups.Materials and Methods: In this prospective, hospital based, interventional, cross-sectional study done over a period of 2 years (July 2015- June 2017), children of various age ranging from 10 days to 8 years who underwent probing and syringing under general anesthesia for CNLDO refractory to conservative measures were included. Results: Children of as young as 10 days to as older as 8 years underwent probing and syringing with male to female ratio of 1.2:1. Overall success was 80.6% (58/72) which was statistically significant when analyzed with age (P = 0.006). Majority of cases with successful outcome were below 24 months of age (90.62%). There was predominance of membranous obstruction (128/194) over bony obstruction (66/194). Conclusions: Nasolacrimal duct probing under GA is a safe and viable option as a primary treatment modality for CNLDO. Though the success of probing is high in the younger children, it’s worthwhile to consider the same in older children at least up to 5 years of age before going for more invasive procedure like DCR surgery since more than 2 third of probing has successful outcome up to that age.Asian Journal of Medical Sciences Vol.9(6) 2018 57-61

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