目的：比较中国南方地区与西北地区慢性泪囊炎患者的菌群分布，明确细菌谱的地理差异性，对不同地区抗生素使用因地制宜提供依据。方法：本研究为回顾性横断面研究。纳入2022年3月—2024年4月在中国西北地区三甲医院眼科诊断为慢性泪囊炎，拟行泪囊鼻腔吻合术的患者，并选取同时期在中国南方地区诊断为慢性泪囊炎的患者，所有患者在行经鼻镜泪囊鼻腔吻合术时切开泪囊取泪囊分泌物。两组标本均行一般细菌及真菌培养，比较两组细菌培养阳性率和构成比。结果：南方地区和西北地区泪囊分泌物细菌培养阳性率分别为26.0%和50.7%，差异有统计学意义(P < 0.001)。南方地区细菌分布中革兰阳性球菌、革兰阴性杆菌的构成比分别为 45.9%、37.6%，西北地区两种菌构成比为 71.4%、19.0%，差异有统计学意义(分别为P = 0.007，P = 0.003)。两地区检出率最高的菌均为凝固酶阴性葡萄球菌，链球菌属占比在两地区间比较差异有统计学意义(P = 0.004)。结论：中国南方地区比西北地区泪囊分泌物培养阳性率低，慢性泪囊炎细菌谱均以革兰阳性菌为主，南方地区革兰阴性菌占比较西北地区更高，链球菌属检出率较西北地区明显更低。这可能是不同地理环境、不同气候、不同生活习惯等共同因素的结果。

Objective: To compare the bacterial distribution of patients with chronic dacryocystitis from southern China and northwest China and to elucidate the geographical differences in the bacterial spectrum. Methods: This retrospective cross-sectional study included patients diagnosed with chronic dacryocystitis at the ophthalmology departments of tertiary hospitals in southern and northwest China between March 2022 and April 2024. Endoscopic dacryocystorhinostomy was performed on all patients to collect lacrimal sac secretions. The specimens were cultured for bacteria and fungi, and the positive rates and composition ratios of bacterial culture were compared between the two groups. Results: The positive rates of bacterial cultures from lacrimal sac secretions were 26.0% in southern China and 50.7% in northwest China (P < 0.001). The proportions of Gram-positive cocci and Gram-negative bacilli were 45.9% and 37.6%, respectively, in southern China, compared to 71.4% and 19.0%, respectively, in northwest China (P = 0.007 and P = 0.003, respectively). Coagulase-negative staphylococci were the most frequently detected bacteria in both regions. However, the proportion of Streptococcus species was significantly higher in northwest China compared to southern China (P = 0.004). Conclusions: The positive rate of lacrimal sac secretion cultures was lower in southern China compared to northwest China. The bacterial spectrum of chronic dacryocystitis in both regions was predominantly composed of Gram-positive bacteria. However, the proportion of Gram-negative bacteria was higher in southern China, while the detection rate of Streptococcus species was significantly higher in northwest China. These differences may be attributed to variations in climate, geographical features, and lifestyle habits.