Saboo Apoorva, Bennett Ian
Department of Surgery, The University of Queensland, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
ANZ J Surg. 2018 Jul-Aug;88(7-8):739-744. doi: 10.1111/ans.14146. Epub 2017 Oct 18.
The aim of this paper was to retrospectively review non-lactation breast abscesses treated in Princess Alexandra Hospital over a 10-year period and to illustrate the trends in size, risk factors, microbiological profile and management.
A computerized search of the medical records was undertaken to identify all adult patients with a diagnosis of breast abscesses during June 2005-June 2015. Patients concurrently breastfeeding were excluded. A retrospectively review of the clinical records was performed.
Eighty-five abscesses were identified in 77 patients. The median patient age was 45 years and 93.7% were females. Smoking and diabetes mellitus were associated with a longer inpatient hospital stay. There was a significant difference in microbiology of abscesses in relation to size. Smaller abscesses (≤3.0 cm) predominantly had mixed anaerobes (54%), whereas larger abscesses had a dominance of Staphylococcus aureus (29%) and other aerobic microbes (33%) (P < 0.05). Seven percent of all abscesses had methicillin-resistant S. aureus. Flucloxacillin was prescribed solely in majority of the cases (45%) with addition of suitable mixed anaerobic cover in 12% cases. Of the 85 abscesses, 58.8% were managed non-operatively with antibiotics ± percutaneous drainage. Percutaneous aspiration had a shorter inpatient stay compared with patients who underwent operative management.
This represents the first Australian study solely analysing non-lactation breast abscess. Size was correlated significantly to characteristic bacteriology and empiric therapy should include both aerobic and anaerobic cover. The majority of non-lactation breast abscesses can be managed non-operatively with a combination of antibiotics and percutaneous aspiration.
本文旨在回顾性分析亚历山德拉公主医院10年间收治的非哺乳期乳腺脓肿病例，并阐述其大小、危险因素、微生物学特征及治疗趋势。
通过计算机检索病历，识别出2005年6月至2015年6月期间所有诊断为乳腺脓肿的成年患者。排除同时处于哺乳期的患者。对临床记录进行回顾性分析。
共77例患者确诊85处脓肿。患者年龄中位数为45岁，女性占93.7%。吸烟和糖尿病与住院时间延长相关。脓肿的微生物学特征在大小方面存在显著差异。较小的脓肿（≤3.0 cm）主要为混合厌氧菌感染（54%），而较大的脓肿以金黄色葡萄球菌为主（29%），其他需氧菌占33%（P < 0.05）。所有脓肿中有7%为耐甲氧西林金黄色葡萄球菌感染。大多数病例（45%）仅使用氟氯西林治疗，12%的病例加用了合适的混合厌氧菌覆盖治疗。85处脓肿中，58.8%采用抗生素±经皮引流的非手术治疗。与接受手术治疗的患者相比，经皮穿刺抽吸的患者住院时间较短。
这是澳大利亚首项仅分析非哺乳期乳腺脓肿的研究。脓肿大小与特征性细菌学显著相关，经验性治疗应同时覆盖需氧菌和厌氧菌。大多数非哺乳期乳腺脓肿可通过抗生素和经皮穿刺抽吸联合进行非手术治疗。
