title: Mastitis and methicillin-resistant Staphylococcus aureus (MRSA): the calm before the storm?
abstract: BACKGROUND
  Post-partum mastitis is a common infection in breastfeeding women, with an incidence of 9.5-16% in recent literature. Over the past decade, community-acquired methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a significant pathogen in soft-tissue infections presenting to the emergency department. The incidence of mastitis caused by MRSA is unknown at this time, but likely increasing.
  
  
  OBJECTIVE
  We review the data on prevention and treatment of mastitis and address recent literature demonstrating increases in MRSA infections in the post-partum population and how we should change our practices in light of this emerging pathogen.
  
  
  METHODS
  We present a case of simple mastitis in a health care worker who failed to improve until treated with antibiotics appropriate for a MRSA infection.
  
  
  CONCLUSIONS
  Recent evidence suggests that just as MRSA has become the prominent pathogen in other soft-tissue infections, mastitis is now increasingly caused by this pathogen. Physicians caring for patients with mastitis need to be aware of this bacteriologic shift to treat appropriately.
authors.affiliation: Department of Emergency Medicine, George Washington University, Washington, DC, USA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Schoenfeld
authors.forename: Mary Pat
authors.initials: MP
authors.lastname: McKay
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002981:Clindamycin / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy; D005260:Female; D006801:Humans; D008413:Mastitis / Q000188:drug therapy* / Q000382:microbiology; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D013203:Staphylococcal Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D002981:Clindamycin