The Role of Staphylococcus aureus in Mastitis: A Multidisciplinary Working Group Experience. (August 2020)

• Record Type: Journal Article
• Authors: Rimoldi, Sara Giordana; Pileri, Paola; Mazzocco, Martina Ilaria; Romeri, Francesca; Bestetti, Giovanna; Calvagna, Nunziata; Tonielli, Claudia; Fiori, Lorenza; Gigantiello, Anna; Pagani, Cristina; Magistrelli, Paolo; Sartani, Alessandra; De Silvestri, Annalisa; Gismondo, Maria Rita; Cetin, Irene
• Is Part Of: Journal of human lactation. Volume 36:Number 3(2020:Aug.)
• Page Start: 503
• Page End: 509
• Publication Date: 2020-08
• Subjects: anatomy -- breast -- breastfeeding -- human milk; Breastfeeding -- Periodicals; Lactation -- Periodicals; 612.664
• DOI: 10.1177/0890334419876272
• Languages: English
• ISSNs: 0890-3344

Abstract

Background: Breastfeeding women are at risk of developing mastitis during the lactation period. Staphylococcus aureus has emerged as the community-acquired pathogen responsible for virulence (methicillin resistance and Panton-Valentine leukocidin toxin producing). Research aim: The aim was to compare the microorganisms responsible for mastitis and breast abscesses during breastfeeding. Methods: This observational study was conducted with a sample of women ( N = 60) admitted to our hospital between 2016 and 2018. Participants affected by mastitis and breast abscess were studied and cared for by a multidisciplinary working group. A diagnostic breast ultrasound identified the pathology. Results: Twenty-six participants (43.3%) were affected by mastitis and 34 (56.7%) by breast abscess. The most common microorganism identified was Staphylococcus aureus ( S. aureus ; mastitis, n = 13; abscesses, n = 24). Methicillin resistance was identified in 21 (44.7%) S. aureus strains: 17 (80.9%) cases of abscess and four (19.1%) cases of mastitis. The median number of months of breastfeeding was smaller in the methicillin-resistant S. aureus (MRSA) cases (median = 3, range = 1–20 months) than in the methicillin-sensitive S. aureus (MSSA) cases (median = 6.5, range = 3–21 months). The Panton-Valentine leukocidin toxin gene was detected in 12 (25.5%) cases (MRSA, n = 8, 66.7%; MSSA, n = 4, 33.3%). Hospitalization was required more frequently in MRSA ( n = 8, 38%; five Panton-Valentine leukocidin positive) than in MSSA cases ( n = 5, 19%; one Panton-Valentine leukocidin positive). Four women out of the eight MRSA cases (50%) that were Panton-Valentine leukocidin positive stopped breastfeeding during mammary pathologies, three (37.5%) participants continued breastfeeding until the follow-up recall, and one case was lost at follow-up. Conclusion: Clinical severity was probably complicated by the presence of the Panton-Valentine leukocidin toxin, which required hospitalization more frequently.