Characteristics of the clinical forms and optimization of treatment of dacryocystitis in the newborns

Aim. To optimize the treatment of dacryocystitis in the newborns, to reduce the frequency of recurrent nasolacrimal duct catheterization. Methods. Examined were 207 children suffering from catarrhal (the first group - 57 children, 73 affected eyes), purulent (the second group - 139 children, 158 eyes) and phlegmonous (the third group - 11 children, 12 eyes) dacryocystitis. A control group was also formed - 12 children without inflammatory eye diseases. Conducted was a clinical examination, determined was the lysozyme activity of the tears, analyzed was the effectiveness of medicinal and surgical treatment, and conducted was a microbiological investigation with the study of sensitivity of the pathogenic microorganisms to antibacterial drugs. Results. In catarrhal dacryocystitis of the newborns identified were seven species of microorganisms, most commonly found were S. epidermidis (more than 50%) and S. aureus (12.4%), in 19.2% of cases no pathogen was identified. The etiology of purulent dacryocystitis was more diverse - 23 species of pathogens, the leading pathogens were S. aureus (15.2%), S. pneumoniae and S. epidermidis (13.9% each), E. faecium (8.2%). In the phlegmonous form of the disease revealed were 4 types of pathogens, most commonly S. epidermidis (45.5%) and S. aureus (27.2%). In 9.1% of cases no pathogen was identified. The causative agents of catarrhal and purulent dacryocystitis of the newborns showed the greatest sensitivity to pikloxydine (100% and 93.3%), chloramphenicol (86.7% and 79.7%) and ciprofloxacin (87.0% and 72.2%). Revealed was the reduction of lysozyme activity of the tears both in the affected and in the unaffected eyes of children with dacryocystitis. During the analysis of the results of surgical treatment the frequency of relapses in the first group (catarrhal dacryocystitis of the newborns) was 8.3%, while in the second group (purulent dacryocystitis) it was significantly higher - 13.7%. Conclusion. In order to reduce the frequency of relapses conservative treatment should be conducted with respect to the microbial etiology, forms of the disease, and sensitivity of pathogens to antimicrobial agents before catheterization of the nasolacrimal duct.

dacryocystitis, newborns, antibiotics, microbiological sensitivity