Ma Hongye, Zeng Yifei, Qu Di, Huang Xiaoxia, Wang Xuanyu, Gao Xiang, Guo Honglin
Clin Lab. 2025 Jul 1;71(7). doi: 10.7754/Clin.Lab.2025.250235.
The aim was to comprehensively explore the distribution of pathogenic bacteria and antimicrobial susceptibility in the breast puncture fluid of the patients with non-lactation granulomatous mastitis to optimize treatment programs.
Fifteen strains of pathogenic bacteria isolated from the breast puncture fluid of the patients with non-lactation granulomatous mastitis were collected in the breast department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University from March 2023 to October 2023. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA sequencing were used to bacterial identi-fication. The E-test method was used to determine the minimum inhibitory concentration (MIC) for each isolate, and the EUCAST standard was used for conducting the antimicrobial susceptibility interpretation. The control lipophilic experiment was performed by adopting the 1% Tween-80 blood plate.
The mean age of 15 patients with non-lactation granulomatous mastitis was 32.73 ± 3.37 years old, of which 14 (93.3%) had a history of pregnancy, and the mean postpartum mastitis was 6.38 ± 9.65 months. MALDL-TOF MS results were consistent with 16S rRNA sequencing by nanopore. Among the isolated fastidious bacteria, there were 15 strains of Corynebacterium kroppenstedtii (CK). These strains showed a high susceptibility rate to rifampicin and ceftriaxone (respectively, 93.3% and 80%). The resistance rate of penicillin was as high as 80%. The resistance rate of ciprofloxacin was 46.7%, and the intermediate rate was 53.3%. The sensitivity rate of moxifloxacin was 53.3%. There were no vancomycin-resistant or linezolid-resistant strains found.
CK plays an important role in the occurrence and development of non-lactation granulomatous mastitis. According to the analysis of clinical antibiotic medication norms and drug sensitivity results, lipophilic rifampicin and linezolid may be the preferred empirical drugs for CK-related non-lactation granulomatous mastitis patients. Meanwhile, the clinical laboratory should endeavor to optimize the culture conditions and use MALDL-TOF MS for accurate identification to improve the detection rate of culture.
旨在全面探究非哺乳期肉芽肿性乳腺炎患者乳房穿刺液中病原菌的分布及抗菌药物敏感性，以优化治疗方案。
收集2023年3月至2023年10月首都医科大学附属北京中医医院乳腺科从非哺乳期肉芽肿性乳腺炎患者乳房穿刺液中分离出的15株病原菌。采用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）和16S rRNA测序进行细菌鉴定。采用E-test法测定各分离株的最低抑菌浓度（MIC），并按照欧洲抗菌药物敏感性试验委员会（EUCAST）标准进行抗菌药物敏感性判读。采用1%吐温-80血平板进行亲脂性对照试验。
15例非哺乳期肉芽肿性乳腺炎患者的平均年龄为32.73±3.37岁，其中14例（93.3%）有妊娠史，产后乳腺炎平均时间为6.38±9.65个月。MALDL-TOF MS结果与纳米孔16S rRNA测序结果一致。在分离出的苛养菌中，有15株克氏棒状杆菌（CK）。这些菌株对利福平和头孢曲松显示出较高的敏感率（分别为93.3%和80%）。青霉素的耐药率高达80%。环丙沙星的耐药率为46.7%，中介率为53.3%。莫西沙星的敏感率为53.3%。未发现耐万古霉素或耐利奈唑胺的菌株。
CK在非哺乳期肉芽肿性乳腺炎的发生发展中起重要作用。根据临床抗生素用药规范及药敏结果分析，亲脂性利福平和利奈唑胺可能是CK相关非哺乳期肉芽肿性乳腺炎患者的首选经验性用药。同时，临床实验室应努力优化培养条件，采用MALDL-TOF MS进行准确鉴定，以提高培养检出率。
