Liang Zuxin, Zeng Zhujun, Liao Yanqiang, Cao Yaxin, Li Dongmei, Deng Ningbo, Lei Yeyan, Long Xuanhui, Shen Chenguang, Xu Rui
BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Department of Laboratory Medicine, Guangdong Provincial Hospital of Chinese Medicine, Zhuhai, China.
Front Microbiol. 2024 Dec 23;15:1501204. doi: 10.3389/fmicb.2024.1501204. eCollection 2024.
Previous microbiological investigations have demonstrated a significant correlation between complex (CKC) infection and mastitis. Recent studies have confirmed the existence of the CKC, with () identified as the primary infectious agent. Examining the incidence of CKC in cases of severe non-lactational mastitis, alongside the clinical characteristics of infected patients, as well as evaluating the drug sensitivity testing protocols for CKC, can provide a more robust foundation for the diagnosis and treatment of CKC infections.
Data regarding the diagnosis and treatment of non-nursing patients with severe mastitis who underwent surgical intervention were extracted from the hospital's electronic medical record system. Additionally, drug susceptibility tests were conducted on 15 strains of CKC isolated from mammary abscesses as well as DSM 44385 model strains. The effects of β-NAD and Tween80 (TW80) on the antibiotic susceptibility test by AGAR dilution and micro broth dilution were analyzed.
In this study, accounted for 80% (12/15) of the isolates, while made up 13.3% (2/15), and was identified in only 6.7% (1/15) of the cases. There were significant differences in age at first delivery ( < 0.001), prolactin ( < 0.001), CRP ( < 0.05), WBC ( < 0.05), and NEUT ( < 0.05) between CKC positive group and CKC negative group. In the AGAR dilution test, the addition of β-NAD only caused acceptable differences in penicillin G and ciprofloxacin but did not affect 12 antibiotics. There are 14 drugs with good coincidence rates (92.9%) in the micro broth dilution method and agar dilution method without the addition of β-NAD. The addition of 0.05% (v/v) TW80 resulted in all strains being resistant to penicillin G. Daptomycin is not suitable for the micro broth dilution method.
Elderly primiparas with high prolactin levels have a higher risk of CKC infection. The micro broth dilution method is not applicable for EUCAST drug susceptibility testing for CKC and there is no suitable drug susceptibility evaluation procedure for daptomycin against CKC.
先前的微生物学调查表明，复杂（CKC）感染与乳腺炎之间存在显著相关性。最近的研究证实了CKC的存在，其中（）被确定为主要感染病原体。研究严重非哺乳期乳腺炎病例中CKC的发病率，以及感染患者的临床特征，并评估CKC的药敏试验方案，可为CKC感染的诊断和治疗提供更坚实的基础。
从医院电子病历系统中提取接受手术干预的严重乳腺炎非哺乳患者的诊断和治疗数据。此外，对从乳腺脓肿分离出的15株CKC菌株以及DSM 44385模式菌株进行药敏试验。分析了β-NAD和吐温80（TW80）对琼脂稀释法和微量肉汤稀释法抗生素药敏试验的影响。
在本研究中，（）占分离株的80%（12/15），而（）占13.3%（2/15），仅6.7%（1/15）的病例中鉴定出（）。CKC阳性组和CKC阴性组在初产年龄（<0.001）、催乳素（<0.001）、CRP（<0.05）、白细胞（<0.05）和中性粒细胞（<0.05）方面存在显著差异。在琼脂稀释试验中，添加β-NAD仅导致青霉素G和环丙沙星出现可接受的差异，但不影响12种抗生素。在不添加β-NAD的情况下，微量肉汤稀释法和琼脂稀释法中有14种药物的符合率良好（92.9%）。添加0.05%（v/v）TW80导致所有菌株对青霉素G耐药。达托霉素不适用于微量肉汤稀释法。
催乳素水平高的老年初产妇发生CKC感染的风险较高。微量肉汤稀释法不适用于CKC的EUCAST药敏试验，且没有适用于达托霉素对CKC的药敏评估程序。
