Bacteriology of non-oncologic post-operative breast infections: A retrospective cross-sectional study to guide empiric antibiotic coverage
Abstract
BACKGROUND: Antibiotic prophylaxis for non-oncologic breast surgeries is not well described by procedure type. This study identified the underlying microbiological etiologies and antibiotic sensitivities of culture-positive infections from non-oncologic breast surgeries that were performed at a major medical center to guide specific empiric antibiotic coverage.
METHODS: A retrospective cohort study was conducted at a tertiary hospital from November 2018 to January 2024. Patients aged ≥18 years who underwent non-oncologic breast surgery with culture-confirmed infections were included. Procedures analyzed included mastopexy, augmentation, reduction, gender-affirming surgery, and prophylactic mastectomies with and without reconstruction. Organism profiles from the procedures with >1 culture-positive infection were compared with their antibiogram to guide empiric treatment.
RESULTS: Among the 3457 non-oncologic breast procedures, 37 resulted in culture-positive infections (1.07%). Infected patients were older (mean age 44 vs 37 years, p<0.05), but no significant differences in sex, body mass index, tobacco use, or comorbidities were noted. Infection rates were similar between prosthetic (1.04%) and non-prosthetic (1.08%) procedures (p=0.94) but were significantly higher in the risk-reducing mastectomy cohort (3.65% vs 0.92%, p<0.01). Organism profiles varied with the procedure. Organisms isolated from all procedures were sensitive to vancomycin. Empiric treatment recommendations…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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