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乳腺炎患者中棒状杆菌感染的临床特征和复发情况。

Clinical features and recurrence of Corynebacterium kroppenstedtii infection in patients with mastitis.

机构信息

The Second People's Hospital of Longgang District, Shenzhen, 518112, China.

Shenzhen Baoan Women's and Children's Hospital, Jinan University, No. 56, Yulv Road, Baoan, Shenzhen, 518102, China.

出版信息

BMC Womens Health. 2022 Jul 6;22(1):276. doi: 10.1186/s12905-022-01859-y.

Abstract

BACKGROUND

Few studies have investigated the differences in clinical features of patients with mastitis following Corynebacterium kroppenstedtii infection, and most focused on the bacterial antimicrobial susceptibility, detection methods and therapy.

METHODOLOGY

There were 133 patients with mastitis infected by C. kroppenstedtii between August 2016 and September 2019. C. kroppenstedtii was identified using mass spectrometry. The demographics, clinical diagnosis, laboratory test results of different types of mastitis combined with bacillus infection, and the effects of different treatments in reducing recurrence were compared.

RESULTS

The incidence of pus following C. kroppenstedtii infection was higher in patients with non-granulomatous lobular mastitis (NGLM; 56.6%) than in those with granulomatous lobular mastitis (GLM; 33.3%; χ = 7.072, p = 0.008). While C-reactive protein (CRP) was higher in the GLM group (12.50 mg/L) than in the NGLM group (6.05 mg/L; Z =  - 2.187, p = 0.029). Treatment with local lavage (triamcinolone acetonide) and antibiotics (cefuroxime) showed a recurrent rate of 25.9% in C. kroppenstedtii infection.

CONCLUSION

Increased pus, large masses, and an elevated CRP level may occur in patients with mastitis infected by C.kroppenstedtii. These clinical features may guide the determination of the bacterial infection in patients with mastitis. Combining an antibiotic with a triamcinolone acetonide lavage, preferably cefuroxime, may reduce the recurrence.

摘要

背景

鲜有研究调查过科氏葡萄球菌感染性乳腺炎患者的临床特征差异,大多数研究集中在细菌的抗菌药敏性、检测方法和治疗上。

方法

2016 年 8 月至 2019 年 9 月期间,共有 133 例乳腺炎患者感染科氏葡萄球菌。采用质谱法鉴定科氏葡萄球菌。比较不同类型乳腺炎合并棒状杆菌感染患者的人口统计学、临床诊断、实验室检查结果,以及不同治疗方法降低复发率的效果。

结果

非肉芽肿性小叶性乳腺炎(NGLM)患者中,科氏葡萄球菌感染后出现脓液的比例(56.6%)高于肉芽肿性小叶性乳腺炎(GLM)患者(33.3%;χ²=7.072,p=0.008)。GLM 组的 C 反应蛋白(CRP)水平(12.50mg/L)高于 NGLM 组(6.05mg/L;Z=-2.187,p=0.029)。局部灌洗(曲安奈德)和抗生素(头孢呋辛)联合治疗科氏葡萄球菌感染的复发率为 25.9%。

结论

科氏葡萄球菌感染性乳腺炎患者可能出现脓液增多、肿块较大和 CRP 水平升高的情况。这些临床特征可能有助于确定乳腺炎患者的细菌感染。联合应用抗生素和曲安奈德灌洗(优选头孢呋辛)可能降低复发率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75ed/9258122/657218ee8491/12905_2022_1859_Fig1_HTML.jpg

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