Puerperal mastitis in the past decade: results of a single institution analysis
Although puerperal mastitis is a common disease, published data are poor. Increasing rates of community-acquired MRSA (CA-MRSA) cases are reported in the USA. However, information about common pathogens and CA-MRSA in Germany is still insufficient. The aim of this study was to investigate the most common pathogens of puerperal mastitis in the last decade, its therapy, resistance rate and the effectiveness of the current treatment strategies.
The pathogens, the respective antibiograms and the treatment strategies of patients treated for puerperal mastits at the University Clinic Magdeburg (Germany) between 2006 and 2016 were retrospectively reviewed. Statistical analysis was performed using SPSS Version 21.
In our series, 59 cases with puerperal mastitis were reviewed, 26 (44.1%) of these developed a breast abscess. In 37 of 59 (67.3%) cases the symptoms occurred in the first 8 weeks postpartum. The most common pathogens were Staphylococcus aureus (64.9%) and Coagulase-negative Staphylococcus (13.5%). Methicillin-resistant Staphylococcus aureus (MRSA) was found in one case. Of the 19 cases with Staphylococcus aureus, 17 were resistant to Penicillin. Conservative management was mainly performed with Flucloxacillin (60%), which was successful in most cases. Sixteen of 26 (61.5%) women with abscesses underwent ultrasound (US)-guided needle aspiration.
In this cohort, MRSA was not a main pathogen responsible for breast abscesses. Conservative treatment strategies remained constant during the observed period and Flucloxacillin was the most frequent antibiotic used. The analysis of the courses of diseases leads to the conclusion that surgical incision is progressively replaced by US-guided needle aspiration.
KeywordsLactational breast abscess MRSA Puerperal mastitis Ultrasound-guided needle aspiration
J. Lukassek: data collection, statistical analysis, manuscript writing. A.Ignatov: data management, manuscript writing and editing.J. Faerber: data management, manuscript editing.S.D. Costa: manuscript editing. H. Eggemann: protocol development, data management, manuscript writing and editing.
Compliance with ethical standards
Conflict of interest
We declare that we have no conflict of interest.
Due to the retrospective design of the study ethical approval is not applicable.
Due to the retrospective design of the study an informed consent is not applicable.
- 1.World Health Organization (2000) Mastitis Causes and Management: 1–44Google Scholar
- 7.Mediano P, Fernandez L, Rodriguez JM et al. (2014) Case-control study of risk factors for infectious mastitis in Spanish breastfeeding women. BMC Pregnancy ChildbirthGoogle Scholar
- 13.Bodmann KF, Grabein B, Kresken M et al. S2 k Leitlinie Kalkulierte parenterale Initialtherapie bakterieller Erkrankungen bei Erwachsenen- Update 2018. Paul-Ehrlich-Gesellschaft für Chemotherapie e.V. (PEG): 1–446Google Scholar
- 14.Leitlinie der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe S3 Therapie entzündlicher Bursterkrankungen in der StillzeitGoogle Scholar