Keywords :
Clostridium perfringens, non-lactational breast abscess, Staphylococcus aureus
Citation Information :
Paty BP, Hotta S, Padhi A, Padhi S, Parida B. Bacteriological profile and antimicrobial susceptibility pattern of non-lactational breast abscess. 2019; 21 (2):70-73.
BACKGROUND: Breast abscess is a common condition among OPD female patients. It has been reported that 4.6 % and 11% of the women in developed and developing countries are affected by breast abscess.
AIMS AND OBJECTIVES: To detect the pathogens causing non lactational breast abscess and to determine their antibiotic sensitivity pattern.
MATERIALS AND METHODS: 50 pus samples with diagnosis of non lactational breast abscess were obtained by incision and drainage or by aspiration. Specimens were processed for Gram stain and cultured in both aerobic and anaerobic media. For aerobic blood agar (BA) and Mac-Conkey agar were inoculated. For anaerobic isolation Brucella blood agar (BBA) with 5% sheep blood agar, hemin and vit-k were inoculated and Metronidazole disc was placed in primary streaking line. Plates were incubated in Mark-II Anaerobic system. Isolates were identified by Gram stain, biochemical tests and sensitivities to identification discs like Vancomycin, Kanamycin, Colistin and SPS. Sensitivity patterns of the aerobic isolates were determined by Kirby-Bauer disc diffusion method.
RESULTS: Maximum no of cases belongs to age group of 36-45 years (42%). Out of the 50 pus samples 36(72%) were found to be culture positive from which 42 number of bacteria were isolated. Aerobes and facultative anaerobes predominated 30(71%) over the anaerobes 12 (29%). Staphylococcus aureus 11(36%) was found to be the predominant organism. Clostridium perfringens 6(50%) was the commonest anaerobe isolated. Gram positive isolates were sensitive to Clindamycin, Linezolid and Vancomycin and gram negative bacteria were sensitive to Imipenem and Piperacillin-Tazobactam. Percentage of MRSA was 43%. Amongst the gram negative bacteria ESBL production was seen in 55% of isolates.
CONCLUSION: Breast abscess is a fairly common surgical problem among both lactational and non-lactational females. Besides aerobes non-lactating breast abscesses also showed the presence of anaerobic bacteria. As minimally invasive management of breast abscesses, such as ultrasound guided drainage with systemic antibiotic drug therapy is the treatment of choice it is essential to provide the appropriate empirical antibiotic therapy in this drug resistance era.
Cunningham RM. Abscess in the non-lactating breast. Am Surg 1967;33:339-43.
Dixon JM. ABC of breast diseases. Breast infection. BMJ 1994;309:946-9.
Dixon JM, Khan LR. Treatment of breast infection. BMJ 2011;342:d396.
Sheybani F, Sarvghad M, Naderi HR, Gharib M. Treatment for and clinical characteristics of granulomatous mastitis. Obstet Gynecol 2015;125:801-7.
Ferrara JJ, Leveque J, Dyess DL, Lorino CO. Nonsurgical management of breast infections in nonlactating women. A word of caution. Am Surg 1990;56:668-71.
Edmiston CE Jr, Walker AP, Krepel CJ, Gohr C. The nonpuerperal breast infection: Aerobic and anaerobic microbial recovery from acute and chronic disease. J Infect Dis 1990;162:695-9.
Matheson I, Aursnes I, Horgen M, Aabø O, Melby K. Bacteriological findings and clinical symptoms in relation to clinical outcome in puerperal mastitis. Acta Obstet Gynecol Scand 1988;67:723-6.
Jain BK, Sehgal VN, Jagdish S, Ratnakar C, Smile SR. Primary actinomycosis of the breast: A clinical review and a case report. J Dermatol 1994;21:497-500.
Simpson AJ, Jumaa PA, Das SS. Breast abscess caused by Nocardia asteroides. J Infect 1995;30:266-7.
Jun SY, Jang J, Ahn SH, Park JM, Gong G. Paragonimiasis of the breast. Report of a case diagnosed by fine needle aspiration. Acta Cytol 2003;47:685-7.
Cohen C. Tuberculous mastitis. A review of 34 cases. S Afr Med J 1977;52:12-4.
Collee JG, Miles RS, Watt B. Tests for identification of bacteria. In: Collee JG, Fraser AG, Marimon BP, Simmons A, editors. Mackie & McCartney Practical Medical Microbiology. Haryana, India: Churchill Livingstone. 2016. p. 131-50.
Garcia LS, editor. Clinical Microbiology Procedures Handbook. Washington, DC: American Society for Microbiology Press; 2010.
Winn WC. Koneman's Color Atlas and Textbook of Diagnostic Microbiology. Philadelphia: Lippincott Williams & Wilkins; 2006.
Meguid MM, Oler A, Numann PJ, Khan S. Pathogenesis-based treatment of recurring subareolar breast abscesses. Surgery 1995;118:775-82.
Dixon JM. Outpatient treatment of non-lactational breast abscesses. Br J Surg 1992;79:56-7.
Christensen AF, Al-Suliman N, Nielsen KR, Vejborg I, Severinsen N, Christensen H, et al. Ultrasound-guided drainage of breast abscesses: Results in 151 patients. Br J Radiol 2005;78:186-8.
Thirumalaikumar S, Kommu S. Best evidence topic reports. Aspiration of breast abscesses. Emerg Med J 2004;21:333-4.
Ekland DA, Zeigler MG. Abscess in the nonlactating breast. Arch Surg 1973;107:398-401.
Sandhu GS, Gill HS, Sandhu GK, Gill GP, Gill AK. Bacteriology in Breast Abscesses. Sch J App Med Sci 2014;2:1469-72.
Ingham HR, Tharagonnet D, Sisson PR, Selkon JB, Codd AA. Inhibition of phagocytosis in vitro by obligate anaerobes. Lancet 1977;2:1252-4.
Lev M, Keudell KC, Milford AF. Succinate as a growth factor for Bacteroides melaninogenicus. J Bacteriol 1971;108:175-8.
Mergenhagen SE, Thonard JC, Scherp HW. Studies on synergistic infections. I. Experimental infections with anaerobic streptococci. J Infect Dis 1958;103:33-44.
Brook L. Microbiology of non-puerperal breast abscesses. J Infect Dis 1988;157:377-9.