MRSA breast abscesses in postpartum women

Infections caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are being increasingly observed in patients who lack traditional risk factors. While mastitis and breast abscesses are commonly encountered in post-natal women, CA-MRSA breast infections have rarely been reported.

We reviewed 15 postpartum women with methicillin-resistant Staphylococcus aureus (MRSA) breast abscesses observed in our unit from June 2005 to April 2007. Ultrasonographic examination was performed in all cases. MRSA infection was diagnosed on microbiological analysis cultured from the abscesses of these patients.

The median age of the patients was 31.5 years. The majority of the patients were primiparae (80%). Only one patient was immunocompromised. None of the patients had history of previous breast infection and none developed recurrence. Eleven patients (73.3%) underwent aspiration of pus and four patients (26.7%) underwent incision and drainage. All the cultures were sensitive to co-trimoxazole and vancomycin. Eight (53.3%) of the cultures were also sensitive to erythromycin.

CA-MRSA is an emerging problem in our obstetric population. CA-MRSA breast infections are clinically responsive to common oral antibiotics such as co-trimoxazole and erythromycin. A high index of suspicion is essential to avoid delay in the clinical response to empirical beta-lactams as these patients may benefit from an early change of antibiotics.