Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Nazolakrimal Kanal Tıkanıklığı Olan Olgularda Cerrahi Esnasında Lakrimal Keseden Alınan Örneklerin Mikrobiyolojik Değerlendirmesi ve Uygulanan Tedavinin Cerrahi Başarıya Etkisi
Microbiological Evaluation of Samples Taken From Lacrimal Sac During Surgery in Cases with Nazolacrimal Sac Obstruction and the Effect of Applied Treatment on Surgical Success
İbrahim Ethem AYa, Yasemin NADİRb
aAfyonkarahisar Sandıklı Devlet Hastanesi, Göz Hastalıkları Kliniği, Afyonkarahisar, TÜRKİYE
bAfyonkarahisar Sandıklı Devlet Hastanesi, Enfeksiyon Hastalıkları Kliniği, Afyonkarahisar, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2021;30(2):130-4
doi: 10.5336/ophthal.2020-79611
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmada, nazolakrimal kanal tıkanıklığı (NLKT) olan olgularda cerrahi esnasında lakrimal keseden alınan örneklerin mikrobiyolojik değerlendirmesi ve uygulanan tedavinin cerrahi başarıya etkisini incelemek amaçlandı. Gereç ve Yöntemler: Eylül 2019 ve Eylül 2020 arasında, NLKT nedeniyle eksternal dakriyosistorinostomi uygulanan olguların cerrahi esnasında lakrimal keseden alınan lavaj materyallerinin, kültür sonuçları geriye dönük olarak incelendi. Üreyen bakterilerin gram pozitif ve gram negatif olarak görülme sıklığı, antibiyotik duyarlılıkları ve uygulanan tedavinin cerrahi başarıya etkileri değerlendirildi. Bulgular: Olguların 3'ü erkek, 53'ü kadın idi. Yaş ortalaması 62,3±6,2 olarak bulundu. Ortalama takip süresi 7,8±2,1 ay idi. Kültür sonucu pozitif saptanan 23 (%38,9) olgunun, 14 (%60)'ünde gram pozitif ve 9 (%40)'unda gram negatif bakteri saptandı. En sık görülen gram pozitif mikroorganizmalar sırasıyla; Staphylococcus aureus (%34,7) ve Streptococcus pneumoniae (%17,3), en sık görülen gram negatif bakteri ise Pseudomonas aeruginosa (%26) oldu. Tespit edilen bakterilere karşı en etkili antibiyotikler; gatifloksasin (%100), sefotaksim (%100) ve amikasin (%95,2) olarak bulundu. Amoksisilin (%40,8) en az etkili antibiyotik olarak göze çarptı. Üreme bulunan 6 olguda, üreme saptanmayan bir olguda cerrahi sonrası değişik zamanlarda izlenen nüks saptandı. Sonuç: Kültür sonuçları, antibiyotik duyarlılık oranları, gram pozitif ve gram negatif etkenlerin görülme sıklığı açısından literatürle kıyaslandığında benzer sonuçlar bulunmuştur. Kültürde üreme olanlarda, izlenen nüks artımı nedeniyle şüpheli olgularda cerrahi esnasında örnek alınması ve gerekirse uygun tedavi uygulanarak sık aralıklarla kontrol edilmesi gereklidir.

Anahtar Kelimeler: Dakriyosistorinostomi; kültür antibiyogram; mikroorganizma
ABSTRACT
 Objective: In this study, it was aimed to examine the microbiological evaluation of the samples taken from the lacrimal sac during surgery in patients with nasolacrimal duct obstruction and the effect of the applied treatment on surgical success. Material and Methods: Culture results of lavage materials taken from the lacrimal sac during surgery in patients who underwent external dacryocystorhynostomy due to nasolacrimal duct obstruction between September 2019 and September 2020 were retrospectively analyzed. The frequency of grampositive and gram-negative growth of bacteria, antibiotic susceptibility and the effects of treatment on surgical success were examined. Results: Three of the cases were male and 53 were female. The mean age was 62.3±6.2. The mean follow-up time was 7.8±2.1 months. Of the 23 cases (38.9%) with positive culture results, 14 (60%) had gram positive and 9 (40%) gram negative bacteria. The most common gram positive microorganisms were Staphylococcus aureus (34.7%) and Streptococcus pneumoniae (17.3%) and the most common gram negative bacteria was Pseudomonas aeruginosa (26%). The most effective antibiotics against the detected bacteria were gatifloxacin (100%), cefotaxime (100%) and amikacin (95.2%). Amoxicillin (40.8%) stood out as the least effective antibiotic. Recurrence was detected at different times after surgery in 6 cases with reproduction and in one without. Conclusion: Similar results were found when compared with the literature in terms of culture results, antibiotic susceptibility rates, and the frequency of gram-positive and gram-negative factors. Because of the increase in recurrence observed in those with culture reproduction, it is necessary to take samples during surgery in suspicious cases and apply appropriate treatment if necessary to be checked frequently.

Keywords: Dacryocystorhynostomy; culture antibiogram; microorganism
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