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Arteaga K, Aftab G, Rajaei SM, Faghihi H, Crasta M. Comparison of conjunctival microbiota of clinically normal Persian cats with and without nasolacrimal duct obstruction. Vet Ophthalmol 2021; 24:455-459. [PMID: 34402572 DOI: 10.1111/vop.12925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study was performed to determine the conjunctival microbiota of Persian cats with and without nasolacrimal duct obstruction (NLDO). ANIMALS STUDIED Twenty-five Persian cats: 15 with bilateral NLDO (Group A) and 10 with no NLDO (Group B). PROCEDURES All fifty eyes were assessed. Sterile swab applicators were used for the collection of specimens, which were cultured. PCR was performed on conjunctival swab and blood samples for the detection of Mycoplasma spp. and feline herpesvirus 1(FHV-1), respectively. RESULTS FHV-1 was detected in two cats in Group A. Twelve eyes from Group A and four from Group B were Mycoplasma spp. positive based on the PCR results. Moreover, fungal culture was positive in six eyes from Group A and three eyes from Group B. The dominant fungus isolated was Aspergillus spp. (6 out of 11 fungal isolates). Other isolated fungi were Alternaria spp. and Cladosporidium spp. Twenty-three eyes had positive bacterial culture in Group A, while twelve eyes were positive in Group B. The most commonly isolated bacteria were Staphylococcus epidermidis (15 out of 38 bacterial isolates). β-hemolytic Streptococcus spp., Corynebacterium spp., and Staphylococcus aureus were isolated in similar proportions in both groups. Escherichia coli was also present in both groups. CONCLUSIONS Results of this study revealed same isolated fungal and bacterial spp. and in similar proportions in Persian cats with and without NLDO.
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Affiliation(s)
| | - Ghazal Aftab
- Department of Clinical Sciences, College of Veterinary Medicine, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Seyed Mehdi Rajaei
- Ophthalmology section, Negah Veterinary Centre, Tehran, Iran.,Department of Clinical Sciences, College of Veterinary Medicine, Karaj Branch, Islamic Azad University, Alborz, Iran
| | - Houman Faghihi
- Department of Clinical Sciences, College of Veterinary Medicine, Science and Research Branch, Islamic Azad University, Tehran, Iran.,Ophthalmology section, Negah Veterinary Centre, Tehran, Iran
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Nuzzi R, Tridico F, Nuzzi A. Dacryocystectomy with Lacrimal Silicone Intubation in Challenging Patients Affected by Recurrent Dacryocystitis and Epiphora: Expanding Minimally Invasive Approach Indications. Open Ophthalmol J 2020. [DOI: 10.2174/1874364102014010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
In this study, we evaluated the feasibility and safety of dacryocystectomy associated with lacrimal intubation, for the treatment of recurrent dacryocystitis and epiphora secondary to lacrimal obstruction with compromised lacrimal sac, was evaluated.
Subjects and Methods:
32 patients underwent dacryocystectomy with Crawford tubes canalicular insertion, performed by a single surgeon. Post-operative visits were scheduled at 1st and 10th day, 1, 3, and 6 months. At each follow-up visit, the prevalence of epiphora and dacryocystitis was evaluated and compared with baseline data. Also, we evaluated the prevalence of local and systemic post-operative adverse events during the follow-up period.
Results:
11 patients (34.38%) reported persistent epiphora, which lasted for 30 days after surgery. Among them, 9 subjects (28.13%) complained occasional epiphora even at the six months follow-up. In the event of dacryocystitis or subacute phlogosis before surgery, patients reported a definitive symptom resolution. Other reported adverse events were epithelial corneal erosion due to Crawford tube protrusion (4 cases, 12.5%), a Crawford tube extrusion case (3.13%), 3 cases of surgical wound dehiscence (9.36%), and a case of mild local bleeding persisting for 15 days
Conclusion:
A significative epiphora reduction was observed after surgery with an acceptable safety profile, expanding dacryocystectomy indications. This procedure provides a satisfactory resolution of recurrent dacryocystitis. However, this approach should be performed only in well-selected cases: elderly/frail patients with altered lacrimal sacs, epiphora associated with recurrent infections, and failure after dacryocystectomy.
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Hiraoka T, Hoshi S, Tasaki K, Oshika T. Assessment of conjunctival flora in eyes with lacrimal passage obstruction before and after successful dacryoendoscopic recanalisation. Br J Ophthalmol 2020; 105:909-913. [PMID: 32713839 DOI: 10.1136/bjophthalmol-2020-316264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/17/2020] [Accepted: 06/25/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND To investigate conjunctival bacterial flora in eyes with lacrimal passage obstruction before and after dacryoendoscopic recanalisation with lacrimal tube intubation. METHODS One-hundred fifty eyes with lacrimal passage obstruction that were successfully treated by dacryoendoscopic recanalisation were enrolled. Conjunctival sampling was done for each eye before and 4 months after surgery. The lower fornix was rubbed by a sterile cotton swab, and the collected samples were cultured with several agar plates. Colonies were differentiated and enumerated by standard bacteriological laboratory techniques. RESULTS Positive bacterial growth was detected in 42.0% of all the samples before surgery, and the positivity rate significantly decreased to 26.0% after surgery (p=0.0051). The number of strains detected also decreased from 20 before surgery to 9 after surgery, especially pathogenic microorganisms decreased. In addition, drug-resistant bacteria such as penicillin-resistant Streptococcus pneumoniae and methicillin-resistant Staphylococcus aureus were detected in nine eyes before surgery but were detected only in one eye after surgery. Coagulase-negative Staphylococci and Corynebacterium spp., which are common in normal conjunctival flora, accounted for 46.5% of all the isolates before surgery and 80.9% after surgery, showing a significant increase in the rate after surgery (p<0.0001). CONCLUSIONS This study showed that physiological recanalisation of lacrimal passage after dacryoendoscopic surgery significantly decreased the culture positivity rate of conjunctival sac and the number of microorganism strains detected. It also decreased the number of potentially pathogenic and drug-resistant bacteria and increased the percentages of indigenous bacteria, causing the normalisation of conjunctival flora.
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Affiliation(s)
- Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Tsukuba Japan
| | - Sujin Hoshi
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Tsukuba Japan
| | - Kuniharu Tasaki
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Tsukuba Japan
| | - Tetsuro Oshika
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Tsukuba Japan
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Vinciguerra A, Nonis A, Resti AG, Bussi M, Trimarchi M. Impact of Post-Surgical Therapies on Endoscopic and External Dacryocystorhinostomy: Systematic Review and Meta-Analysis. Am J Rhinol Allergy 2020; 34:846-856. [DOI: 10.1177/1945892420945218] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Epiphora is a common ophthalmologic sign that is most commonly caused by distal acquired lacrimal obstruction. Recent data have demonstrated that external dacryocystorhinostomy (EXT-DCR) and endoscopic endonasal dacryocystorhinostomy (END-DCR) can be considered the treatments of choice. However, different post-surgical medical therapies are available and are currently used to improve surgical outcomes, although no direct comparison has been performed. Objective To analyse the influence of post-surgical medical treatments on END-DCR and EXT-DCR outcomes. Methods A structured search was conducted using the U.S. National Library of Medicine (PubMed), EMBASE, SCOPUS, and Cochrane databases with a final search performed in May 2020. The research identified papers published later than 2000 with at least 50 single clinician procedures performed in EXT-DCR and END-DCR. Articles that studied acute infections, revision cases, mixed cohort studies of acquired and congenital obstruction, and tumour were excluded. The influence of systemic antibiotic/steroids, local application of mitomycin C, nasal/ocular antibiotic, nasal/ocular steroids and nasal decongestants was analysed. Results In total, 11,445 papers were selected, 2,741 of which were reviewed after screening, and 18 included after full text review (0.6% of the initial articles reviewed) which involved 3,590 procedures. Considering the low number of publications on EXT-DCR, statistical analysis of post-surgical therapy was not feasible. In END-DCR, the analyses were performed only for nasal steroids (p = 0.58), oral antibiotics (p = 0.45) and nasal decongestant (p = 0.27), which demonstrated no meaningful influence. Given the variable association between adjunctive medical therapies, pharmacologic molecular heterogeneity and modality/concentration of application, these results should be considered critically. Additionally, no differences were seen for application of silicone stenting, whereas, no statistical analysis was performed for mitomycin C. Conclusions Given the high success rate of EXT-DCR and END-DCR and the heterogeneity of literature data, the effective influence of post-surgical medical therapy is difficult to identify. Future large prospective randomized studies could help in detecting the optimal adjunctive therapy for these surgeries.
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Affiliation(s)
- Alessandro Vinciguerra
- Division of Head and Neck Department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milano, Italy
| | - Alessandro Nonis
- CUSSB, University Centre for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milano, Italy
| | - Antonio Giordano Resti
- Division of Head and Neck Department, Ophthalmologic Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Mario Bussi
- Division of Head and Neck Department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milano, Italy
| | - Matteo Trimarchi
- Division of Head and Neck Department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milano, Italy
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Toribio A, Marrodán T, Fernández-Natal I, Martínez-Blanco H, Rodríguez-Aparicio L, Ferrero MÁ. Conjunctival flora in anophthalmic patients: microbiological spectrum and antibiotic sensitivity. Int J Ophthalmol 2019; 12:765-773. [PMID: 31131234 DOI: 10.18240/ijo.2019.05.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 02/24/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To identify the spectrum and susceptibility pattern of isolated microorganisms from conjunctival flora of anophthalmic patients. METHODS A cross-sectional clinical study including 60 patients with unilateral anophthalmia. Patients with use of antibiotic drops in their socket during the last month were also included. From each patient, three microbiological samples were taken from the lower conjunctival sac (healthy eye, pre-prosthesis, and retro-prosthesis space of socket). The 180 samples obtained were cultured. Isolates were identified and their antibiotic sensitivities were determined. RESULTS A total of 251 isolates were recovered (62 isolates from healthy eye, 93 from pre-prosthesis, and 96 from retro-prosthesis space). The most common organism was Staphylococcus epidermidis, in both healthy eyes (64.5%) and sockets (45.5%). Altogether, coagulase-positive Staphylococci, Streptococci, and Gram-negative bacteria accounted for less than 15% of isolates in healthy eyes and more than 35% in sockets. Regarding the antibiotic sensitivities, there were no significant differences between isolates from sockets and healthy eyes. Nine patients recognized the use of self-prescribed antibiotic drops in their socket. In the healthy eyes of these subjects, Gram-positive microorganisms showed significantly greater resistance to aminoglycosides and tetracycline. CONCLUSION Sockets of anophthalmic patients show a greater number of pathogens compared to healthy eyes. The use of antibiotic drops in the socket promotes a resistant flora not only in the socket but also in the healthy eye. Quinolones and macrolides may be better therapeutic options than aminoglycosides for treating conjunctivitis of anophthalmic sockets, since these antibiotics are less active against Staphylococcus epidermidis.
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Affiliation(s)
- Alvaro Toribio
- Department of Ophthalmology, University Hospital of León, León 24071, Spain
| | - Teresa Marrodán
- Department of Clinical Microbiology, University Hospital of León, León 24071, Spain
| | | | | | | | - Miguel Á Ferrero
- Department of Molecular Biology, University of León, León 24007, Spain
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