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Breast implant infections: is cefazolin enough?
Evan M Feldman1, Dimitrios P Kontoyiannis, Safa E Sharabi
1Houston, Texas From the Division of Plastic Surgery, Baylor College of Medicine, and the Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center.
Plastic and Reconstructive Surgery
|September 3, 2010
Summary
Breast implant infections are often caused by Staphylococcus aureus, with a high rate of methicillin-resistance. Antibiotics targeting methicillin-resistant Staphylococcus aureus are recommended for empiric treatment of these infections.
Area of Science:
- Infectious Diseases
- Plastic Surgery
- Microbiology
Background:
- Bacterial infections are a significant risk following breast implant surgery, with incidence rates varying by procedure type.
- Current guidelines lack specific recommendations for empiric treatment of established breast implant infections.
- Rising rates of methicillin-resistant Staphylococcus aureus (MRSA) necessitate exploring alternative antibiotic strategies.
Purpose of the Study:
- To analyze the bacteriology and antibiotic susceptibility patterns of breast implant-related infections.
- To establish a baseline for empiric antibiotic therapy for breast implant infections.
- To evaluate the prevalence of MRSA in these infections.
Main Methods:
- Retrospective review of patients with periprosthetic infections within one month of breast implant placement (2001-2006).
- Inclusion criteria required documented culture data for infected breasts.
- Analysis of 116 infected breasts from 106 patients.
Main Results:
- Staphylococcus aureus was identified in 67% of infected breasts.
- Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 68% of S. aureus infections.
- Gram-negative rods were found in 6% of cases, and 26% yielded sterile cultures.
Conclusions:
- The high prevalence of MRSA in breast implant infections supports using antibiotics with anti-MRSA activity for empiric treatment.
- Empiric therapy should be guided by local susceptibility data until definitive culture results are available.
- This approach aims to improve outcomes for patients with breast implant infections.
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