title: [Methicillin-resistant Staphylococcus aureus (MRSA) isolation in breast abscesses in a Public Maternity].
abstract: Mastitis and breast abscess in lactating women are risk factors for early breastfeeding cessation. This pathology is included in the group of skin and soft tissue infections. A descriptive study was performed with an advanced outlook. As of January 2007 through December 2011 a total of 137 breast abscesses were treated in our institution. We analyzed incidence, parity, postpartum days, risk factors, microbiological isolation and the adequacy of initial antibiotic treatment. In that period we observed a steady and significant increase in breast abscesses. Incidence from 0.19 to 0.84% in lactating women 2007 vs. 2011 p = 0.0001 IC 95% (-0.009; 0.003), 70.6% of them primiparous and a mean interval from delivery to breast abscess of 41.9 ± 35.8 days. The most frequent risk factors were sore nipples and breast engorgement. Staphylococcus aureus was isolated in 82.3 to 95.0%. Methicillin resistance was higher than 60%. These strains were susceptible to erythromycin, clindamycin, gentamicin, rifampicin, ciprofloxacin and trimethoprim-sulfamethoxazol. All the cases were surgically drained; the initial empirical treatment was inadequate in 60% of them, 90% of patients could maintain breast feeding after the procedure.
  
  
  CONCLUSIONS
  these data emphasize the need to prevent risk factors associated to breast abscesses: sore nipples and breast engorgement. In order to determine the adequate antibiotic treatment, bacteriological studies are required at every collection because SAMR prevalence varies according to diverse populations and geographic location.
authors.affiliation: Unidad de Promoción y Protección de la Salud, Hospital Materno Infantil Ramón Sardá, Buenos Aires, Argentina. E-mail: proyprosarda@gmail.com.
authors.forename: Cristina
authors.initials: C
authors.lastname: Boccaccio
authors.forename: Virginia
authors.initials: V
authors.lastname: Verdaguer Babic
authors.forename: Liliana
authors.initials: L
authors.lastname: Botto
authors.forename: María M
authors.initials: MM
authors.lastname: Cervetto
authors.forename: Silvia
authors.initials: S
authors.lastname: Cetani
authors.forename: Silvina
authors.initials: S
authors.lastname: Paladino
authors.forename: Roxana
authors.initials: R
authors.lastname: Conti
authors.forename: Antonio
authors.initials: A
authors.lastname: Lanzillota
authors.forename: Rosa
authors.initials: R
authors.lastname: Herrera
authors.forename: Dora
authors.initials: D
authors.lastname: Amarante
mesh_terms: D000038:Abscess / Q000382:microbiology* / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001118:Argentina / Q000453:epidemiology; D001940:Breast / Q000382:microbiology*; D005260:Female; D006771:Hospitals, Maternity; D006779:Hospitals, Public; D006801:Humans; D006940:Hyperemia / Q000382:microbiology; D015994:Incidence; D007774:Lactation; D008413:Mastitis / Q000150:complications; D059373:Mastodynia / Q000382:microbiology; D016106:Methicillin Resistance / Q000187:drug effects; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D049590:Postpartum Period; D011645:Puerperal Infection; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: breast abscesses; breastfeeding; mastitis; methicillin resistant Staphylococcus aureus