선천 코눈물관 막힘 환자에서 삽입 후 제거된 실리콘관의 배양검사 결과

Abstract

Purpose: We evaluated cultured specimens from silicone tubes removed from patients with congenital nasolacrimal duct obstructionand determined the antibiotic sensitivities of the specimens. Methods: This study included 26 eyes of 22 patients who had received endonasal silicone tube intubation for congenital nasolacrimalduct obstruction. The removed silicone tubes were divided into canaliculus, lacrimal sac, nasolacrimal duct and nasal cavityparts according to insertion state. Then, bacteria and fungus cultures were performed and their antibiotic sensitivity was tested. Results: Bacteria culture rate was 80.8% in the canaliculus and the lacrimal sac, and 88.5% in the lacrimal duct, and the nasal cavity,which was not significantly different according to insertion site. Fungus culture rate was significantly higher in the nasal cavitythan in the nasolacrimal duct and in the nasolacrimal duct than in the lacrimal sac and the canaliculus (p-value < 0.05). The speciesof cultured Gram-positive bacteria were in the following order: Staphylococcus aureus, Streptococcus pneumonia and coagulasenegative Staphylococcus. Common species of cultured Gram-negative bacteria were Pseudomonas and Serratia marcescens. Allsix species of cultured fungi were Candida. Among 12 Staphylococcus aureus cultured, eight species showed resistance to methicillin(MRSA). In all patients, the symptoms and the signs of nasolacrimal duct obstruction improved after the tube removal. Conclusions: Bacterial and fungal infection of the silicone tube in patients with congenital nasolacrimal duct obstruction does notappear to affect directly the outcome of silicone tube intubation. Further studies of bacterium and fungi in the nasolacrimal ductbefore silicone tube intubation are needed for determining the infection causing nasolacrimal duct obstruction.