Clinical characteristics of lactational breast abscess caused by methicillin-resistant Staphylococcus aureus: hospital-based study in China.

BACKGROUND: This study aimed to identify the differences in clinical characteristics, puncture efficacy, antibiotic use, treatment duration, breastfeeding post-illness, and recurrence of patients with breast abscesses caused by methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-susceptible Staphylococcus aureus (MSSA) infection during lactation. METHODS: The clinical data of patients with breast abscesses during lactation who were treated from January 2014 to February 2017 at Haidian Maternal and Child Health Hospital, Beijing, were reviewed. According to bacterial culture results, they were divided into MRSA (n = 260) and MSSA (n = 962) groups. Hospitalization (whether or not the patients were hospitalized), postpartum period, maternal age, location of abscess cavities, number of abscess cavities, amount of pus, frequency of needle aspiration, failure of needle aspiration, antibiotic use, treatment duration, cessation of breastfeeding and recurrence were compared between the two groups using a t-test and a chi-squared test. RESULTS: We noted that only the cessation of breastfeeding was statistically significantly different between the two groups (P = 0.018). Hospitalization, postpartum period, maternal age, location of abscess cavities, number of abscess cavities, amount of pus, number of needle aspiration, failure of needle aspiration, antibiotic use, treatment duration and recurrence showed no statistically significant differences (P = 0.488, P = 0.328, P = 0.494, P = 0.218, P = 0.088, P = 0.102, P = 0.712, P = 0.336, P = 0.512, P = 0.386 and P = 0.359, respectively). CONCLUSIONS: There was no difference in clinical characteristics between breast abscesses infected by MRSA and those infected by MSSA. Ultrasound-guided needle aspiration could be the first choice for MRSA-infected breast abscess treatment. There is no need to increase antibiotic use because of MRSA infection, unless it is necessary. The reason why more patients with MRSA infected breast abscesses terminated breastfeeding is unclear from this study.

Risk Factors for Failure of Ultrasound-Guided Fine-Needle Aspiration Therapy for Lactational Breast Abscess.

Background: Ultrasound-guided fine-needle aspiration in the treatment of breast abscess has become the preferred treatment. Although fine-needle aspiration has a good therapeutic effect, there are still some patients failed who finally underwent drainage. Objective: To analyze the risk factors of ultrasound-guided fine-needle aspiration treatment failure for patients with lactational breast abscess. Materials and Methods: The clinical data of 1,472 patients with lactational breast abscess who underwent ultrasound-guided fine-needle aspiration treatment from January 2014 to March 2017 were analyzed in this retrospective study. According to the treatment results, these patients were divided into two groups: fine-needle aspiration failure group (n = 111) and fine-needle aspiration recovery group (n = 1,361). Chi-square test was used to compare the differences between the two groups in terms of postpartum time, age, location of abscess cavity, number of abscess cavities, volume of pus, frequency of aspiration, infected bacteria, treatment time, weaning, and recurrence. Multivariate logistic regression was used to analyze the risk factors of patients with failed fine-needle aspiration treatment. Results: Univariate analysis showed statistically significant differences in the location of abscess, volume of pus, treatment time, frequency of aspiration, and weaning between the two groups (p < 0.05). Multivariate analysis showed that the location of abscess, volume of pus, frequency of aspiration, and treatment time were risk factors for the failure of ultrasound-guided fine-needle aspiration treatment (p < 0.05). Conclusions: For patients with breast abscess during lactation, abscess in center area, volume of pus >50 mL, frequency of aspiration >3 times and treatment time >14 days, the failure probability of ultrasound-guided fine-needle aspiration treatment was high. Therefore, whether fine-needle aspiration is the preferred treatment for these patients needs to be considered.

Lactational Breast Abscesses Caused by Methicillin-Resistant or Methicillin-Sensitive Staphylococcus aureus Infection and Therapeutic Effect of Ultrasound-Guided Aspiration.

Background and Objective: We investigated whether (1) there are any differences in lactational breast abscesses between patients from whom methicillin-resistant Staphylococcus aureus (MRSA) and those from whom methicillin-sensitive S. aureus (MSSA) were isolated from pus samples and (2) there are differences in the effects of ultrasound-guided aspiration. Materials and Methods: The clinical data of 171 patients with lactational breast abscesses treated by ultrasound-guided aspiration in Beijing from January to July 2018 were retrospectively analyzed. The patients were divided into MSSA infection (N = 132) and MRSA infection (N = 39) groups according to their bacterial culture results. Abscess cavity location, abscess cavity number, maximum abscess cavity size, antibiotic utilization rate, and cure rate were compared between the groups. Cure rate refers to the proportion of the total number of cases remaining after the elimination of failed cases. The number of ultrasound-guided aspiration procedures performed for healing between the two groups was also compared. Results: There were no significant differences in abscess cavity location, abscess cavity amount, and abscess cavity size between both groups. The antibiotic utilization rate of the two groups were 58.3% (MSSA, 77/132) and 69.2% (MRSA, 27/39), respectively, and there were no significant differences between both groups. The cure rates of ultrasound-guided aspiration of the two groups were 97.7% (MSSA, 129/132) and 92.3% (MRSA, 36/39), and there were no significant differences between both groups. There were also no significant differences in the median number of aspiration performed for cure between the MRSA infection group (median = 3, range = 1-10) and the MSSA infection group (median = 3, range = 1-14). Conclusion: Lactational breast abscesses are the same irrespective of the type of S. aureus infection. Treatment by ultrasound-guided aspiration for patients with MRSA infection can achieve the same effect as that for those with MSSA infection.

5-Amino-2-methyl-benzene-sulfonamide.

In the crystal structure of the title compound, C(7)H(10)N(2)O(2)S, a benzoic acid derivative, inter-molecular N-H⋯O inter-actions link the mol-ecules into a three-dimensional network.