Bacteriologic profile and antimicrobial resistance in infants aged 1 year or younger with congenital nasolacrimal duct obstruction.

Abstract

Purpose: The aim of the study was to evaluate conjunctival flora and antibiotic susceptibility in infants aged 1 year or younger with congenital nasolacrimal duct obstruction (CNLDO), creating an overall profile of antimicrobial susceptibility.

Study design: Retrospective.

Methods: The analysis was conducted at the Kazakh Eye Research Institute over a period of 6 years, from January 2017 to December 2022. Cultures were grown on various agars for bacterial and fungal analyses, with sensitivity testing via Vitek 2 Compact.

Results: We examined 1210 conjunctival cultures from infants with CNLDO, yielding 1212 isolates. Most were gram-positive bacteria (77.15%), with fewer gram-negative bacteria (22.28%) and fungi (0.57%). Among the gram-positive bacteria, Staphylococcus species (61.06%) were predominant, including S epidermidis (17.49%), S aureus (10.73%), and S saprophyticus (9.32%). Enterococcus species (6.52%) and Streptococcus species (6.02%) followed. Among the gram-negative bacteria, Escherichia coli (5.78%) was most prevalent, followed by Pseudomonas species. (4.54%), Enterobacter cloacae (3.71%), and Klebsiella species (3.63%). The majority of the fungi were Candida albicans, accounting for 4 isolates (0.33%). Most of the bacteria showed high sensitivity to moxifloxacin (92.52%), levofloxacin (88.99%), gentamicin (86.74%), vancomycin (86.52%), cefotaxime (85.27%), and ofloxacin (85.62%). High resistance was noted for erythromycin (32.84%), clindamycin (28.13%), and tetracycline (21.65%).

Conclusion: In this study, we identified Staphylococcus, Enterococcus, and Streptococcus species and E coli as key CNLDO bacteria and highly responsive to antibiotics like levofloxacin and moxifloxacin. These findings guide effective antibiotic choices for CNLDO treatment, aiding in the prevention of antibiotic resistance.