Acute dacryocystitis: Microbiological profiles from an infectious diseases perspective.

Abstract

Purpose: This study aimed to investigate the microorganisms isolated, antimicrobial resistance patterns, clinical profiles, and therapeutic approaches in adult acute dacryocystitis cases requiring multidisciplinary management, and to present epidemiological data from Turkey.

Methods: We retrospectively analyzed adult patients referred from a tertiary ophthalmology hospital to the infectious diseases (ID) specialist between January 2022 and April 2025. Clinical and microbiological data were obtained from electronic medical records. Pathogen identification and susceptibility testing were performed using routine microbiological methods, and the results were interpreted according to applicable standard criteria.

Results: Sixty-eight patients were included (mean age: 54.9 years; 79.4% female). Of the 68 included patients, 49 underwent microbiological sampling when indicated and sufficient material was available; 38 (77.6%) had positive cultures, yielding 49 isolates. Staphylococcus aureus (n = 12) was the most frequent isolate. Pseudomonas aeruginosa and Enterobacteriaceae were the leading Gram-negative pathogens. All tested Gram-positive isolates were susceptible to vancomycin. Susceptibility to other antibiotics varied across pathogen groups. All fungal isolates were Candida species. Prior antibiotic exposure was not associated with lower culture positivity in this sample.

Conclusion: In adult acute dacryocystitis, culture-based therapy is essential, particularly for complex or nonresponsive cases. This study presents local epidemiological data and may help guide empirical therapy and support individualized antimicrobial management.