Breast abscess bacteriologic features in the era of community-acquired methicillin-resistant Staphylococcus aureus epidemics
Abstract
HYPOTHESIS: Increasing rates of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections have also affected the microbial profile of breast abscesses.
OBJECTIVE: To update the decade-old bacteriologic description of breast abscesses to improve the choice of initial antibacterial drug therapy.
DESIGN: Retrospective case series.
SETTING: County hospital emergency department.
PATIENTS: Forty-four women (mean age, 41 years; age range, 20-63 years) with breast abscesses.
METHODS: All cultures from the breast abscesses of patients were reviewed.
MAIN OUTCOME MEASURES: The microbiologic features and sensitivities of breast abscesses.
RESULTS: Of 46 specimens only 28 showed bacterial yield (61%). Of these, 11 (39%) were polymicrobial, for an average of 1.4 isolates per specimen. The most common organism was S aureus, present in 12 of 37 aerobic cultures (32%), with MRSA in 7 (58%). The remaining organisms included coagulase-negative Staphylococcus (16%), diphtheroids (16%), Pseudomonas aeruginosa (8%), Proteus mirabilis (5%), and other isolates (22%). All MRSA was sensitive to clindamycin, trimethoprim-sulfamethoxazole, and linezolid. Only 2 patients (29%) were sensitive to levofloxacin. Two anaerobic cultures were positive for Propionibacterium acnes and Peptostreptococcus anaerobius.
CONCLUSIONS: Staphylococcus aureus is the most common pathogenic organism in modern breast abscesses. Many breast abscesses have community-acquired MRSA, with more than 50% of…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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