NATIONAL JOURNAL OF MEDICAL RESEARCH print ISSN: 2249 4995│eISSN: 2277 8810 NJMR│Volume 6│Issue 4│Oct – Dec 2016 Page 305 ORIGINAL ARTICLE MICROBIOLOGIC SPECTRUM OF ACUTE AND CHRONIC DACRYOCYSTITIS Abha Gahlot 1 , Shashi Prasad 1 , Manisha Singh 2 , Bhargav Kotadia 3 , Saloni Garg 4 Author’s Affiliations: 1 Professor, 2 Senior Resident, 3 Junior Resident, 4 Intern, Dept. of Ophthalmology, D.Y. Patil Medical College, Pune Correspondence: Dr Manisha Singh Email: manisha.d.singh@gmail.com ABSTRACT Introduction: The aim of this study is to report the microbiological spectrum of dacryocystitis and the antibi- otic sensitivity patterns of the organisms. It was a prospective study done at Department of Ophthalmology, Dr. D. Y. Patil Medical College and Hospital, Pimpri, Pune in 2015 on 42 cases of dacryocystitis. Methodology: Patients were diagnosed with dacryocystitis and on the presence of a pus-filled lacrimal sac and peri lacrimal tissues for acute dacryocystitis. Chronic dacryocystitis patients were diagnosed by ROPLAS Test and sac syringing and were reviewed for demographic and microbiological profile.The culture results, organisms isolated, and their antibiotic sensitivity were studied. Results: In this study 42 clinical samples were evaluated, among them 33(78.5%) were culture positive and rest were reported as no growth 9(21.5%). Among all positive growth, Staphylococcus aureus encountered as the commonest isolate (56%) followed by Streptococcus pneumoniae (2%) among the Gram-positive organisms .In the Gram-negative organisms, Escherichia coli (23%) followed by Pseudomonas aeruginosa (17%) was seen. Gram-positive organisms were commonly sensitive to flouroquinolones, penicillins and vancomycin whereas gram-negative organisms were sensitive to aminoglycosides. Conclusion: Gram-positive and Gram-negative organisms were predominant in this study. The result has sig- nificant bearing on the treatment of patients and also when mass cataract surgeries are being performed. Keywords: Epiphora, Dacrocystitis, Bacteriology INTRODUCTION The mucosa of the lacrimal sac is known to be very resistant to infection. However, this resistance is com- promised by distal obstruction of the nasolacrimal duct 1 and causes infection of the lacrimal sac. Dacro- cystitis might present in two forms. Acute dacryocys- titis is an acute inflammation of the lacrimal sac and presents as tenderness and erythema of the overlying tissues and 23% of eyes might present with lacrimal abscess 1,2 . Chronic dacryocystitis is not only more common than acute dacryocystitis but also has several stages of presentation like epiphora, mucoid dis- charge, conjunctival hyperaemia and chronic conjunc- tivitis 1 . This different presentation may be because of geographical variation in the microbiology of acute and chronic dacryocystitis and also different nasal pa- thologies which seem to play a crucial role in develop- ing dacryocystitis. 3,4 There has been growing noise about changing trends in the microbiologic spectrum of dacryocystitis and where initial studies have shown Gram positive iso- lates predominantly in most studies, some recent stud- ies suggested an increasing frequency in gram negative organisms. 5 Knowledge of the presence of nasolacrimal obstruc- tion and the potential organisms inoculated is there- fore of paramount importance before planning any in- traocular procedure because of the potential risk of endophthalmitis especially in a country like India where we still need to fill a huge lacunae in the number of cataract surgeries. METHODOLOGY This is a prospective study and we included patients with acute and chronic dacryocystitis who underwent microbiological evaluation presenting between 1 st May 2015 to 30 th June,2015 at Dr D Y Patil Medical Col- lege, Pimpri,Pune. The study was performed with the agreement of ethics committee and in accordance with the ethical guide- lines of the hospital. Written informed consents were obtained from all participants. Patients were examined by an ophthalmologist, and cases of dacryocystitis were identified and categorized as acute or chronic, based on their history, signs and symptoms. Acute dacryocystitis was diagnosed in pa- tients with pain, redness, and swelling in the lacrimal sac area(Fig1). Chronic dacryocystitis was diagnosed