目的：探讨急性泪囊炎致病菌和耐药性，为临床合理用药提供依据。

方法：2014-01/2019-10在河北省眼科医院搜集80例急性泪囊炎患者，并抽取泪囊脓液标本做细菌培养及药物敏感试验，分析各年份致病菌菌株的检出率变化，被送检急性泪囊炎致病菌菌种种类，急性泪囊炎的主要致病菌、药物敏感及耐药情况，急性泪囊炎的致病菌平均检出率。

结果：56例标本的致病菌菌株阳性，其中55例为细菌、1例为真菌，平均检出率为70%。各年份致病菌菌株的检出率呈逐渐降低趋势，被送检急性泪囊炎致病菌菌种种类繁多。革兰氏阳性球菌构成急性泪囊炎的主要致病菌，占68%(38例)，以金黄色葡萄球菌为主，占38%(21例)。大部分革兰氏阳性球菌对利福平、左氧氟沙星、氯霉素敏感。革兰氏阴性杆菌对妥布霉素、左氧氟沙星、环丙沙星、庆大霉素较敏感。55例细菌标本对第一、二代头孢菌素有明显耐药。

结论：革兰氏阳性球菌构成急性泪囊炎的主要致病菌，左氧氟沙星可作为治疗急性泪囊炎的首选局部用抗生素。

METHODS: Lacrimal sac pus samples from 80 acute dacryocystitis cases were collected for bacterial culture and drug sensitivity test in Hebei Provincial Eye Hospital from January 2014 to October 2019. The change of detection rate of pathogenic bacteria in different years, the species of pathogenic bacteria of acute dacryocystitis, the main pathogenic bacteria, drug sensitivity and drug resistance of acute dacryocystitis, and the average detection rate of pathogenic bacteria in acute dacryocystitis were analyze.

RESULTS:Totally 56 samples were positive for pathogenic bacteria, including 55 cases of bacteria and 1 case of fungi. The average detection rate was 70%. The detection rate of pathogenic bacteria strains was gradually decreasing year by year, and there were various types of pathogenic bacteria strains detected from samples. In addition, Gram-positive cocci was the main pathogenic bacteria of acute dacryocystitis, accounting for 68%(38 cases), of which, staphylococcus aureus accounted for 38%(21 cases). What's more, most Gram-positive cocci were sensitive to rifampin, levofloxacin, and chloramphenicol, and Gram-negative bacilli were more sensitive to tobramycin, levofloxacin, ciprofloxacin, and gentamicin. Fifty-five cases of bacterial samples were obviously resistant to the first and second generation cephalosporins.

CONCLUSION: Gram-positive cocci constitute the main pathogenic bacteria of acute dacryocystitis, and levofloxacin can be used as the first choice of topical antibiotics for the treatment of acute dacryocystitis.