title: The microbial epidemiology of breast implant infections in a regional referral centre for plastic and reconstructive surgery in the south of France.
abstract: BACKGROUND
  Breast implant infections are usually caused by Staphylococcus aureus and coagulase-negative staphylococci. Gram-negative bacilli are rarely reported to be involved in breast implant infections.
  
  
  METHODS
  Thirty-seven cases of microbiologically confirmed breast implant infection managed from January 2008 to June 2012 in the study centre were reviewed, including 10 cases from the study centre itself and 27 cases from private clinics in the region.
  
  
  RESULTS
  The prevalence of breast implant infection in the study centre was 0.74% of breast implantation, i.e., 3.23% in breast reconstruction for breast cancer and 0.27% in aesthetic breast augmentation (p=0.0002). Of the 37 cases, 30% had undergone radiotherapy and 11% had undergone a lymph node dissection. S. aureus was identified in 18 cases, Gram-negative bacilli in 10 cases, coagulase-negative staphylococci in eight cases, anaerobic bacteria in eight cases, and streptococci in three cases. Pseudomonas aeruginosa was the second most commonly identified pathogen. Staphylococcus epidermidis was the most frequent coagulase-negative Staphylococcus species. In addition to Propionibacterium acnes and Actinomyces neuii, other facultative and strict anaerobic bacteria have not been reported before, e.g., Bacteroides thetaiotaomicron, Corynebacterium simulans, Dermabacter hominis, Finegoldia magna, and Peptoniphilus harei. Seventy-percent of cases were treated by immediate implant removal. All cases treated only with antibiotics were treated with surgery at the second visit.
  
  
  CONCLUSIONS
  The microbiological epidemiology was noted by an increasing the proportion of Gram-negative bacteria and anaerobic bacteria detected with the advent of MALDI-TOF MS and molecular identification for diagnosis.
authors.affiliation: Service de Maladies Infectieuses et Tropicales, CHU de la Conception, 147, boulevard Baille, Marseille, France; Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France; Institut Hospitalo-Universitaire Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Cliniques et Biologique, Assistance Publique des Hôpitaux de Marseille, Marseille, France. Electronic address: sengpiseth@yahoo.fr.
authors.forename: Piseth
authors.initials: P
authors.lastname: Seng
authors.affiliation: Service de Maladies Infectieuses et Tropicales, CHU de la Conception, 147, boulevard Baille, Marseille, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Bayle
authors.affiliation: Service de Chirurgie Plastique Reconstructrice et Esthétique, CHU de la Conception, Marseille, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Alliez
authors.affiliation: Service d'Informatique Médicale, CHU de la Conception, Marseille, France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Romain
authors.affiliation: Service de Chirurgie Plastique Reconstructrice et Esthétique, CHU de la Conception, Marseille, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Casanova
authors.affiliation: Service de Maladies Infectieuses et Tropicales, CHU de la Conception, 147, boulevard Baille, Marseille, France; Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France; Institut Hospitalo-Universitaire Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Cliniques et Biologique, Assistance Publique des Hôpitaux de Marseille, Marseille, France.
authors.forename: Andreas
authors.initials: A
authors.lastname: Stein
mesh_terms: D000328:Adult; D000368:Aged; D001419:Bacteria / Q000235:genetics / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D001941:Breast Diseases / Q000453:epidemiology / Q000382:microbiology*; D018427:Breast Implants; D005260:Female; D005602:France; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006801:Humans; D016462:Mammaplasty; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012017:Referral and Consultation; D013210:Staphylococcus / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000302:isolation & purification; D055815:Young Adult
keywords: Anaerobic bacteria; Breast implant infection; Gram-negative bacteria; Human; Pseudomonas aeruginosa