Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Texas Medical School-Houston, Houston, Texas 77030, USA.
Breastfeed Med. 2010 Jun;5(3):113-5. doi: 10.1089/bfm.2009.0030.
The study objective is to determine the incidence of methicillin-resistant Staphylococcus aureus (MRSA) in postpartum breast abscesses in two Houston, TX, area hospitals.
This is a retrospective chart review of women hospitalized for postpartum breast abscesses at Woman's Hospital of Texas and Memorial Hermann Hospital between January 1, 2000 and December 31, 2006. Patients were identified by searching admission records for ICD-9 codes related to breast abscesses. Demographic characteristics, medical history, culture results, and pertinent procedures were recorded. Statistical analyses included the Fisher exact test for categorical data and Student's test for continuous variables.
Thirty-three postpartum abscesses were identified: 19 from Memorial Hermann Hospital and 14 from Woman's Hospital. MRSA and S. aureus were the only causative bacteria identified. Twelve of the 19 abscesses from Hermann Hospital were MRSA positive (63%), and nine of the 14 from Woman's Hospital were MRSA positive (64%). There were no statistically significant differences among women with MRSA abscesses versus those with S. aureus abscesses in terms of ethnicity, age, time to presentation, parity, insurance, or mode of delivery. Susceptibility patterns were consistent with community-acquired MRSA.
MRSA is a significant pathogen in postpartum breast abscesses in our population, and a high level of suspicion is warranted. Local susceptibility patterns should guide treatment. Empirical treatment of breast abscesses without first obtaining cultures should be discouraged.
本研究旨在确定德克萨斯州休斯顿地区两家医院产后乳腺炎脓肿中耐甲氧西林金黄色葡萄球菌（MRSA）的发生率。
这是对 2000 年 1 月 1 日至 2006 年 12 月 31 日期间在德克萨斯州妇女医院和纪念赫尔曼医院住院治疗产后乳腺炎脓肿的女性进行的回顾性图表审查。通过搜索与乳腺炎脓肿相关的 ICD-9 代码来确定患者。记录人口统计学特征、病史、培养结果和相关手术。统计分析包括分类数据的 Fisher 确切检验和连续变量的 Student's t 检验。
共发现 33 例产后脓肿：19 例来自纪念赫尔曼医院，14 例来自妇女医院。MRSA 和金黄色葡萄球菌是唯一确定的致病细菌。赫尔曼医院的 19 个脓肿中有 12 个（63%）是 MRSA 阳性，妇女医院的 14 个脓肿中有 9 个（64%）是 MRSA 阳性。MRSA 脓肿与金黄色葡萄球菌脓肿的女性在种族、年龄、就诊时间、产次、保险和分娩方式方面无统计学差异。药敏模式与社区获得性 MRSA 一致。
MRSA 是我们人群中产后乳腺炎脓肿的重要病原体，应高度怀疑。应根据当地药敏模式进行治疗。不首先获取培养物就对乳腺炎脓肿进行经验性治疗应予以避免。
