Abstract：
BACKGROUND: The aim was to clarify the distributions of bacteria in the conjunctival sac and lacrimal sac in patients with chronic dacryocystitis.
METHODS: In total, 297 (322 eyes) chronic dacryocystitis patients who underwent nasal endoscopic dacryocystorhinostomy (EN-DCR) were included. Conjunctival sac secretions from the affected eye were collected preoperatively, and lacrimal sac retention fluid from the affected side in the same patient was collected intraoperatively. Bacterial culture and drug sensitivity testing were performed to determine bacterial distributions.
RESULTS: In total, 127 bacterial isolates (49 species) were detected in 123 eyes in the conjunctival group, with a positivity rate of 38.2% (123/322); 85 bacterial isolates (30 species) were detected in 85 eyes in the lacrimal sac group, with a positivity rate of 26.4% (85/322). The positivity rates were significantly different (P = 0.001) between two groups. The gram-negative bacilli proportion in the lacrimal sac group (36/85, 42.4%) was significantly higher than that in the conjunctival sac group (37/127, 29.2%) ( P = 0.047). Positive conjunctival sac secretion culture (123/322) was significantly associated with increased ocular secretion (281/322, 87.3%) (P = 0.002). Among the culture-positive bacteria in the conjunctival sac group and the lacrimal sac group, 30/127, 23.6% and 43/127, 26.7% and 21/85, 24.7% and 20/85, 23.5% were resistant to levofloxacin and tobramycin, respectively.
CONCLUSIONS: This study illustrated differences in bacterial distributions between conjunctival sac secretions and retained lacrimal sac fluid in chronic dacryocystitis patients, with a higher proportion of gram-negative bacilli in lacrimal sac secretions. The ocular surface flora in chronic dacryocystitis patients is partially resistant to levofloxacin and tobramycin, which need to be considered by ophthalmologists.
METHODS: In total, 297 (322 eyes) chronic dacryocystitis patients who underwent nasal endoscopic dacryocystorhinostomy (EN-DCR) were included. Conjunctival sac secretions from the affected eye were collected preoperatively, and lacrimal sac retention fluid from the affected side in the same patient was collected intraoperatively. Bacterial culture and drug sensitivity testing were performed to determine bacterial distributions.
RESULTS: In total, 127 bacterial isolates (49 species) were detected in 123 eyes in the conjunctival group, with a positivity rate of 38.2% (123/322); 85 bacterial isolates (30 species) were detected in 85 eyes in the lacrimal sac group, with a positivity rate of 26.4% (85/322). The positivity rates were significantly different (P = 0.001) between two groups. The gram-negative bacilli proportion in the lacrimal sac group (36/85, 42.4%) was significantly higher than that in the conjunctival sac group (37/127, 29.2%) ( P = 0.047). Positive conjunctival sac secretion culture (123/322) was significantly associated with increased ocular secretion (281/322, 87.3%) (P = 0.002). Among the culture-positive bacteria in the conjunctival sac group and the lacrimal sac group, 30/127, 23.6% and 43/127, 26.7% and 21/85, 24.7% and 20/85, 23.5% were resistant to levofloxacin and tobramycin, respectively.
CONCLUSIONS: This study illustrated differences in bacterial distributions between conjunctival sac secretions and retained lacrimal sac fluid in chronic dacryocystitis patients, with a higher proportion of gram-negative bacilli in lacrimal sac secretions. The ocular surface flora in chronic dacryocystitis patients is partially resistant to levofloxacin and tobramycin, which need to be considered by ophthalmologists.
摘要：
背景：目的是阐明慢性泪囊炎患者结膜囊和泪囊中细菌的分布。
方法：总共，纳入297例（322眼）接受鼻内窥镜泪囊鼻腔造口术（EN-DCR）的慢性泪囊炎患者。术前收集患眼结膜囊分泌物，术中收集同一患者患侧的泪囊滞留液。进行细菌培养和药物敏感性测试以确定细菌分布。
结果：总计，结膜组123只眼检测到127株细菌(49种),阳性率为38.2%(123/322);泪囊组85眼检测到85株细菌(30种),阳性率为26.4%(85/322)。两组阳性率差异有统计学意义(P=0.001)。泪囊组革兰阴性杆菌比例(36/85,42.4%)明显高于结膜囊组(37/127,29.2%)(P=0.047)。结膜囊分泌培养阳性（123/322）与眼部分泌增加（281/322，87.3％）显着相关（P=0.002）。结膜囊组和泪囊组培养阳性菌中,30/127,23.6%和43/127,26.7%和21/85,24.7%和20/85,23.5%对左氧氟沙星和妥布霉素耐药,分别。
结论：这项研究说明了慢性泪囊炎患者结膜囊分泌物和保留的泪囊液之间细菌分布的差异，泪囊分泌物中革兰阴性杆菌的比例较高。慢性泪囊炎患者眼表菌群对左氧氟沙星和妥布霉素部分耐药,这需要眼科医生考虑。
方法：总共，纳入297例（322眼）接受鼻内窥镜泪囊鼻腔造口术（EN-DCR）的慢性泪囊炎患者。术前收集患眼结膜囊分泌物，术中收集同一患者患侧的泪囊滞留液。进行细菌培养和药物敏感性测试以确定细菌分布。
结果：总计，结膜组123只眼检测到127株细菌(49种),阳性率为38.2%(123/322);泪囊组85眼检测到85株细菌(30种),阳性率为26.4%(85/322)。两组阳性率差异有统计学意义(P=0.001)。泪囊组革兰阴性杆菌比例(36/85,42.4%)明显高于结膜囊组(37/127,29.2%)(P=0.047)。结膜囊分泌培养阳性（123/322）与眼部分泌增加（281/322，87.3％）显着相关（P=0.002）。结膜囊组和泪囊组培养阳性菌中,30/127,23.6%和43/127,26.7%和21/85,24.7%和20/85,23.5%对左氧氟沙星和妥布霉素耐药,分别。
结论：这项研究说明了慢性泪囊炎患者结膜囊分泌物和保留的泪囊液之间细菌分布的差异，泪囊分泌物中革兰阴性杆菌的比例较高。慢性泪囊炎患者眼表菌群对左氧氟沙星和妥布霉素部分耐药,这需要眼科医生考虑。
