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Yu J, Ding Y, Zhang X, Fang Y, Tai S, Yuan E, Duan Y. Whole-genome sequencing analysis of Staphylococcus aureus isolated from female patients with mastitis in Henan, China. J Glob Antimicrob Resist 2025:S2213-7165(25)00123-7. [PMID: 40419111 DOI: 10.1016/j.jgar.2025.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Revised: 05/14/2025] [Accepted: 05/22/2025] [Indexed: 05/28/2025] Open
Abstract
OBJECTIVES To study the molecular characteristics, antibiotic resistance profiles and virulence features of Staphylococcus aureus (SA) isolates that cause mastitis. METHODS 117 SA isolates were collected from women with mastitis. Strain identification and antimicrobial susceptibility testing were conducted using the Vitek 2 system. All SA isolates were sequenced on the Illumina HiSeq platform. For multilocus sequence typing, ResFinder, spaTyper, and SCCmecFinder were employed to analyse the strains. RESULTS Thirty-five methicillin-resistant Staphylococcus aureus (MRSA) strains and 82 methicillin-sensitive Staphylococcus aureus (MSSA) strains were isolated from women with acute breast abscesses. The rates of resistance to various antibiotics were significantly higher among MRSA isolates than among MSSA isolates. Twenty-two sequence types (STs), 35 staphylococcal protein A (spa) types, and 4 SCCmec types were identified. ST22, ST59, and ST398 were the major lineages, and t309 and t437 were the most common spa types. SCCmec-IVa was the predominant SCCmec type. Interestingly, toxin gene subtypes A (hlgA, hlgB, hlgC, lukF-PV, lukS-PV, seg, sei, sem, sen, seo, seu, n = 54), B (hlgA, hlgB, hlgC, seb, sek, seq, n = 13), C (hlgA, hlgB, hlgC, lukD, lukE, n = 10), and D (hlgA, hlgB, hlgC, n = 10) accounted for 74.4% (87/117) of all SA isolates, suggesting the high expression of virulence genes. CONCLUSIONS ST22, ST398, and ST59 are the main types that cause mastitis and have different virulence factor profiles. This study provides deeper insights into the molecular epidemiology of SA associated with acute mastitis.
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Affiliation(s)
- Jing Yu
- Department of Laboratory Medicine, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China; Zhengzhou Key Laboratory for In Vitro Diagnosis of Hypertensive Disorders of Pregnancy, Zhengzhou, 450052, Henan, People's Republic of China
| | - Yanzi Ding
- Department of Laboratory Medicine, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China; Zhengzhou Key Laboratory for In Vitro Diagnosis of Hypertensive Disorders of Pregnancy, Zhengzhou, 450052, Henan, People's Republic of China
| | - Xue Zhang
- Department of Laboratory Medicine, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China; Zhengzhou Key Laboratory for In Vitro Diagnosis of Hypertensive Disorders of Pregnancy, Zhengzhou, 450052, Henan, People's Republic of China
| | - Yang Fang
- Department of Laboratory Medicine, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China; Zhengzhou Key Laboratory for In Vitro Diagnosis of Hypertensive Disorders of Pregnancy, Zhengzhou, 450052, Henan, People's Republic of China
| | - Shuhong Tai
- Department of Laboratory Medicine, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China; Zhengzhou Key Laboratory for In Vitro Diagnosis of Hypertensive Disorders of Pregnancy, Zhengzhou, 450052, Henan, People's Republic of China
| | - Enwu Yuan
- Department of Laboratory Medicine, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China; Zhengzhou Key Laboratory for In Vitro Diagnosis of Hypertensive Disorders of Pregnancy, Zhengzhou, 450052, Henan, People's Republic of China.
| | - Yitao Duan
- Department of Laboratory Medicine, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China; Zhengzhou Key Laboratory for In Vitro Diagnosis of Hypertensive Disorders of Pregnancy, Zhengzhou, 450052, Henan, People's Republic of China.
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Kazi FF, Batool SZ, Kazi A, Bashir Y. Non-Hodgkin's Lymphoma Within a Breast Abscess in a Male Patient: A Presentation and Literature Review of a Rare Case. Cureus 2024; 16:e67601. [PMID: 39310656 PMCID: PMC11416835 DOI: 10.7759/cureus.67601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2024] [Indexed: 09/25/2024] Open
Abstract
Breast abscesses are a common cause of presentation to the hospital. These should be treated with caution due to the possibility of rare pathology. We present a rare case of a 59-year-old diabetic gentleman who presented to the emergency department with a two-day history of a large right-sided breast swelling along with an area of induration, consistent with an abscess, extending to the right axillary region. Initial laboratory findings revealed elevated inflammatory markers. He was admitted for intravenous antibiotics. A computed tomography (CT) of the thorax performed on admission showed an ill-defined collection in the subcutaneous tissue of the right breast and axilla and an irregular right-sided peribronchial nodule with multiple enlarged pathological lymph nodes. This patient's case was discussed with tertiary specialist breast services and local respiratory teams. He underwent an ultrasound-guided right axillary lymph node biopsy. The histopathology of this revealed a high-grade malignant non-Hodgkin's lymphoma of the diffuse large B-cell (DLBCL) type. He was referred for a positron emission tomography (PET) scan and hematological oncology services for further treatment in the form of chemotherapy. This case presentation brings forward the importance of considering rare diagnoses and unusual histopathology when assessing a male breast lesion.
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Affiliation(s)
- Farah F Kazi
- General Surgery, Midland Regional Hospital Tullamore, Tullamore, IRL
| | | | - Ahmed Kazi
- Surgery, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Yasir Bashir
- General Surgery, Midland Regional Hospital Tullamore, Tullamore, IRL
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Johansson M, Amir LH. 'I don't want to be a guinea pig' - Swedish women's experiences of breast abscess treatment. BMC Womens Health 2024; 24:106. [PMID: 38331786 PMCID: PMC10851594 DOI: 10.1186/s12905-024-02937-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/29/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND It is well known that breastfeeding plays an important role in the health of women and children. However, women are not always given optimal support and most do not reach their breastfeeding goals. About one in five, breastfeeding women report mastitis and a small proportion of these develop a breast abscess. Our aim was to describe the experiences of a group of Swedish breastfeeding women who developed a breast abscess. METHODS A qualitative cross-sectional study with 18 study participants was undertaken in Sweden in 2017-2018. Potential participants were identified through electronic medical records at a university hospital and invited to participate in audio-recorded telephone interviews. Women were between 2 and 24 months postpartum at the time of the interview, on average 8 months. We conducted a thematic analysis in six steps according to Braun and Clark. RESULTS Our analysis identified two themes: 1) Seeking care and receiving treatment was long and unpleasant, and 2) Importance of adequate professional care. Women who experienced a breast abscess were uncertain about where to ask for professional help. They often had a long wait for the right time to undergo the unpleasant and painful procedure of draining their breast abscess. The women felt it was important to receive professional care with respectful communication, continuity of care, and to receive adequate information, but they did not always receive this level of care. CONCLUSIONS Women with puerperal breast abscesses often fall between medical specialty areas. No longer under the care of obstetricians and maternity services, their problem is too complicated for general practitioners or emergency departments, but not regarded as serious by breast surgeons. Healthcare professionals urgently need adequate training in order to deal with breastfeeding problems and be able to offer women-centred care.
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Affiliation(s)
- Margareta Johansson
- Department of Women's and Children's Health, Uppsala University, Akademiska University Hospital, SE-751 85, Uppsala, Sweden.
| | - Lisa H Amir
- Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Bundoora, Victoria, Australia
- Breastfeeding Service, Royal Women's Hospital, Melbourne, Australia
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Yin Y, Cao L, Zhang M, Li Y, Sun C, Ma Q, Liu Z, Li C, Yu Z, Guan X. Integrative proteomic and metabonomic profiling elucidates amino acid and lipid metabolism disorder in CA-MRSA-infected breast abscesses. Front Cell Infect Microbiol 2023; 13:1240743. [PMID: 38029258 PMCID: PMC10679464 DOI: 10.3389/fcimb.2023.1240743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/29/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Bacterial culture and drug sensitivity testing have been the gold standard for confirming community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in breast abscess with a long history. However, these tests may delay treatment and increase the risk of nosocomial infections. To handle and improve this critical situation, this study aimed to explore biomarkers that could facilitate the rapid diagnosis of CA-MRSA infection. Methods This study for the first time applied label-free quantitative proteomics and non-targeted metabonomics to identify potential differentially expressed proteins (DEPs) and differentially expressed metabolites (DEMs) in breast abscess infected with CA-MRSA compared to methicillin-susceptible S. aureus (MSSA). The two omics data were integrated and analyzed using bioinformatics, and the results were validated using Parallel Reaction Monitoring (PRM). Receiver operating characteristic (ROC) curves were generated to evaluate the predictive efficiency of the identified biomarkers for diagnosing CA-MRSA infection. Results After using the above-mentioned strategies, 109 DEPs were identified, out of which 86 were upregulated and 23 were downregulated. Additionally, a total of 61 and 26 DEMs were initially screened in the positive and negative ion modes, respectively. A conjoint analysis indicated that the amino acid metabolism, glycosphingolipid biosynthesis, and glycerophospholipid metabolism pathways were co-enriched by the upstream DEPs and downstream DEMs, which may be involved in structuring the related network of CA-MRSA infection. Furthermore, three significant DEMs, namely, indole-3-acetic acid, L-(-)-methionine, and D-sedoheptulose 7-phosphate, displayed good discriminative abilities in early identification of CA-MRSA infection in ROC analysis. Conclusion As there is limited high-quality evidence and multiple omics research in this field, the explored candidate biomarkers and pathways may provide new insights into the early diagnosis and drug resistance mechanisms of CA-MRSA infection in Chinese women.
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Affiliation(s)
- Yongshuo Yin
- Department of Breast Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Department of Breast Surgery, Shandong University Cancer Center, Jinan, Shandong, China
| | - Lina Cao
- Department of Health Management Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Meng Zhang
- Department of Urology Surgery, Children’s Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Yingjie Li
- Department of Health Management Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Chunhua Sun
- Department of Health Management Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Qinghua Ma
- Department of Breast Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Zhaoyun Liu
- Department of Breast Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Chao Li
- Department of Breast Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Zhiyong Yu
- Department of Breast Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Department of Breast Surgery, Shandong University Cancer Center, Jinan, Shandong, China
| | - Xiao Guan
- Department of Health Management Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Lee CJ, Lai LL, See MH, Velayuthan RD, Doon YK, Lim PE, Lim CSY, Poong SW, Chong CSC, Lee PY, Tan YH. Breaking the Barrier: A Study on Multi-drug Resistance in Breast Abscess at an Academic Malaysian Hospital. World J Surg 2023; 47:2743-2752. [PMID: 37491402 DOI: 10.1007/s00268-023-07108-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND In recent years, the increase in antibiotics usage locally has led to a worrying emergence of multi-drug resistant organisms (MDRO), with the Malaysian prevalence rate of methicillin-resistant Staphylococcus aureus (MRSA) ranging from 17.2 to 28.1% between 1999 and 2017. A study has shown that 7% of all non-lactational breast abscesses are caused by MRSA. Although aspiration offers less morbidities compared to surgical drainage, about 20% of women infected by MRSA who initially underwent aspiration subsequently require surgical drainage. This study is conducted to determine the link between aetiology, antimicrobial resistance pattern and treatment modalities of breast abscesses. METHODS Retrospective study of reviewing microbiology specimens of breast abscess patients treated at Universiti Malaya Medical Centre from 2015 to 2020. Data collected from microbiology database and electronic medical records were analysed using SPSS V21. RESULT A total of 210 specimens from 153 patients were analysed. One-fifth (19.5%) of the specimens isolated were MDRO. Lactational associated infections had the largest proportion of MDR in comparison to non-lactational and secondary infections (38.5%, 21.7%, 25.7%, respectively; p = 0.23). Staphylococcus epidermidis recorded the highest number of MDR (n = 12) followed by S. aureus (n = 8). Adjusted by aetiological groups, the presence of MDRO is linked to failure of single aspirations (p = 0.554) and significantly doubled the risk of undergoing surgical drainage for resolution (p = 0.041). CONCLUSION MDR in breast abscess should be recognised as an increasing healthcare burden due to a paradigm shift of MDRO and a rise of resistance cases among lactational associated infection that were vulnerable to undergo surgical incision and drainage for resolution.
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Affiliation(s)
- Choon Jiat Lee
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Lee Lee Lai
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mee Hoong See
- Breast Surgery Unit, Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
| | | | - Yoke Kiet Doon
- Breast Surgery Unit, Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Phaik Eem Lim
- Institute of Ocean and Earth Sciences, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Crystale Siew Ying Lim
- Department of Biotechnology, Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Sze Wan Poong
- Institute of Ocean and Earth Sciences, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Pui Yuei Lee
- Department of Biotechnology, Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Yong Hui Tan
- Department of Biotechnology, Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia
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Jin LH, Zheng HL, Lin YX, Yang Y, Liu JL, Li RL, Ye HJ. Lactation breast abscess treated with Gualou Xiaoyong decoction and painless lactation manipulation: A case report and review of literature. World J Clin Cases 2023; 11:1847-1856. [PMID: 36970011 PMCID: PMC10037288 DOI: 10.12998/wjcc.v11.i8.1847] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/09/2023] [Accepted: 02/07/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND Breast abscess during lactation is a severe complication of acute mastitis, which can lead to discomfort, high fever, breast fistula, sepsis, septic shock, breast damage, disease persistence and frequent hospitalization. Breast abscesses may also lead the mother to discontinue breastfeeding, thereby harming the infant’s health. The predominant pathogenic bacteria are Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus. The incidence of breastfeeding abscesses in breastfeeding women ranges between 4.0% and 11.0%. In cases of breast abscess, the rate of cessation of lactation is 41.0%. In instances of breast fistula, the rate of cessation of lactation is very high (66.7%). Furthermore, 50.0% of women with breast abscesses must be hospitalized and treated with intravenous antibiotics. Treatment includes antibiotics, abscess puncture and surgical incision and drainage. The patients suffer from stress, pain and easily induced breast scarring; the disease’s progression is prolonged and recurrent, interfering with infant feeding. Consequently, it is crucial to discover an adequate cure.
CASE SUMMARY A 28-year-old woman with a breast abscess was treated with Gualou Xiaoyong decoction and painless breast opening manipulation 24 d after cesarean delivery. On the 2nd d of treatment, the patient’s breast mass was significantly reduced, the pain was significantly reduced, and the general asthenia was improved. All conscious symptoms disappeared after 3 d, breast abscesses faded after 12 d of treatment, inflammation images disappeared after 27 d, and normal lactation images were restored.
CONCLUSION In treating breast abscesses during breastfeeding, the combination of Gualou Xiaoyong decoction and painless lactation provides a positive therapeutic impact. This disease’s treatment offers the advantages of a short course of treatment, no need to discontinue breastfeeding and the ability to rapidly mitigate symptoms, which can be used as a reference in clinical practice.
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Affiliation(s)
- Li-Hua Jin
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Xinhua Hospital of Zhejiang Province, Hangzhou 310005, Zhejiang Province, China
| | - Hui-Ling Zheng
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Xinhua Hospital of Zhejiang Province, Hangzhou 310005, Zhejiang Province, China
| | - Yun-Xia Lin
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Xinhua Hospital of Zhejiang Province, Hangzhou 310005, Zhejiang Province, China
| | - Yi Yang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Xinhua Hospital of Zhejiang Province, Hangzhou 310005, Zhejiang Province, China
| | - Jia-Li Liu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Xinhua Hospital of Zhejiang Province, Hangzhou 310005, Zhejiang Province, China
| | - Rui-Lan Li
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Xinhua Hospital of Zhejiang Province, Hangzhou 310005, Zhejiang Province, China
| | - Hui-Jun Ye
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Xinhua Hospital of Zhejiang Province, Hangzhou 310005, Zhejiang Province, China
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