Antibiotic Resistance in Breastfeeding Diseases: A Multidisciplinary Study in an Italian Level III Medical Center

Antimicrobial resistance is a global concern. It is particularly impactful during breastfeeding infections when identifying risk factors and protective mechanisms is crucial.

This study aimed to assess the prevalence of antibiotic resistance among breastfeeding women diagnosed with mastitis and breast abscesses.

A cross-sectional analysis of longitudinal data was conducted at a Level III medical center in Italy from January 2016 to December 2020. A total of 203 women were enrolled following diagnoses of mastitis or breast abscesses.

Among the 156 women who tested positive for Staphylococcus aureus infection, culture antibiograms identified 29.6% as methicillin-resistant Staphylococcus aureus (MRSA). Additionally, six women exhibited clindamycin-resistant S. aureus. Exclusive breastfeeding at discharge (OR = 0.40, 95% CI [0.26, 0.84], p = 0.01) and rooming-in (OR = 0.34, 95% CI [0.15, 0.79], p = 0.01) were significantly associated with reduced odds of methicillin-resistant infections; although these findings are based on unadjusted odds ratios. Conversely, the use of breastfeeding aids in-hospital was not significantly associated with odds of resistant bacterial infections (OR 2.02, 95% CI [0.97, 4.18], p = 0.06).

This study underscores the antibiotic resistance scenario of microorganisms causing mastitis and abscesses in our setting. Implementing microbiological surveillance in mother-child settings could aid in identifying local resistance patterns.