Breast Infections And The Superbug
It seems that most nursing mothers hospitalized for breast infections culture positive for the superbug known as methicillin-resistant Staphylococcus aureus (MRSA). But don't be alarmed, it sounds worse than it is. A new study performed by physicians at the UT Southwestern Medical Center has shown that conservative treatment seems to keep the problem under control. MRSA was found in higher incidences in women who suffered from an inflammation of the milk ducts (mastitis) along with abscesses.
The major finding of this study which was published in the September 2008 issue of Obstetrics and Gynecology is that patients with mastitis may not need antibiotic treatment against MRSA. Lead author of the study, Dr. George Wendel, a professor of obstetrics and gynecology comments, "She will improve with a less specific antibiotic as long as she also empties her breasts, either through feeding or pumping, and if there's an abscess, gets it treated."
The study demonstrated that if a nursing mother is found to have an abscess, she doesn't need to be placed on antibiotic therapy that is specific for MRSA but can try more conservative antibiotic therapy until test results prove positive for MRSA. If MRSA is found to be present, the patient can switch to the appropriate medication.
The purpose of the study was to determine which antibiotic therapy is the most effective for a severe bout of mastitis. Mastitis is caused by a clogging of the milk ducts in nursing women. There may or may not be infection present and sometimes an abscess will form in the breast.
Abscesses are caused by bacterial infections, most often by aureus. While there are many strains of staph, only one of them is the virulent MRSA. The problem with treating MRSA is that the strong medications used to fight the bacteria carry with them the risk of producing ever more drug-resistant strains of staph.
Dr. Wendel's team found that physicians don't have to rush—they can take their time determining which bacteria are responsible for the infection. "We found that you're not going to put the patient at a disadvantage if you start her on antibiotics while you wait for culture results, then switch her to more powerful medication if she has MRSA," said Wendel.
136, 459 women gave birth at Parkland Memorial Hospital between 1997 and 2005. Of these women, 127 were hospitalized for mastitis. 59% of those women who suffered from both mastitis and abscesses were found to have MRSA, while only 2% of the women without abscesses had the superbug. The researchers found that in cases where women were started on the usual course of antibiotic therapy, only to be later found positive for MRSA; making the switch to the stronger medication (vancomycin) indicated for the condition did the trick in all cases.
Some 2-10% of all lactating women end up with some type of breast inflammation, for example, mastitis. The symptoms of mastitis include flu-like symptoms with fever, soreness felt deep in the breast, or swelling in one breast. An abscess is characterized by heat, pain, and redness in one spot on the skin of the breast.