Puerperal mastitis requiring hospitalization during a nine-year period

To review the clinical and microbiologic features of isolates among patients with puerperal mastitis requiring hospitalization.

Between January 2000 and December 2008, postpartum patients who were hospitalized for mastitis were enrolled. The clinical characteristics, microbiologic results, management, and outcomes were reviewed.

One hundred twenty-seven cases were enrolled. Seventy-six patients (59.9%) underwent incision and drainage for abscess drainage, all of whom discontinued breastfeeding. Staphylococcus aureus and coagulase-negative staphylococci were the most common isolates. Among 81 isolates of S aureus, 52 (64.2%) were resistant to oxacillin. Patients undergoing incision and drainage were more likely to discontinue breastfeeding, had a longer duration of symptoms, a longer hospitalization, a higher platelet count and higher rates of infection caused by S aureus and oxacillin-resistant S aureus.

Oxacillin-resistant S aureus has emerged in patients with puerperal mastitis during the past decade, and often necessitates incision and drainage, which results in discontinuation of breastfeeding.