Bacteriological profile and antimicrobial susceptibility pattern of non-lactational breast abscess

Abstract

BACKGROUND: Breast abscess is a common condition among OPD female patients. It has been reported that 4.6 % and 11% of the women in developed and developing countries are affected by breast abscess. AIMS AND OBJECTIVES: To detect the pathogens causing non lactational breast abscess and to determine their antibiotic sensitivity pattern. MATERIALS AND METHODS: 50 pus samples with diagnosis of non lactational breast abscess were obtained by incision and drainage or by aspiration. Specimens were processed for Gram stain and cultured in both aerobic and anaerobic media. For aerobic blood agar (BA) and Mac-Conkey agar were inoculated. For anaerobic isolation Brucella blood agar (BBA) with 5% sheep blood agar, hemin and vit-k were inoculated and Metronidazole disc was placed in primary streaking line. Plates were incubated in Mark-II Anaerobic system. Isolates were identified by Gram stain, biochemical tests and sensitivities to identification discs like Vancomycin, Kanamycin, Colistin and SPS. Sensitivity patterns of the aerobic isolates were determined by Kirby-Bauer disc diffusion method. RESULTS: Maximum no of cases belongs to age group of 36-45 years (42%). Out of the 50 pus samples 36(72%) were found to be culture positive from which 42 number of bacteria were isolated. Aerobes and facultative anaerobes predominated 30(71%) over the anaerobes 12 (29%). Staphylococcus aureus 11(36%) was found to be the predominant organism. Clostridium perfringens 6(50%) was the commonest anaerobe isolated. Gram positive isolates were sensitive to Clindamycin, Linezolid and Vancomycin and gram negative bacteria were sensitive to Imipenem and Piperacillin-Tazobactam. Percentage of MRSA was 43% .Amongst the gram negative bacteria ESBL production was seen in 55% of isolates. CONCLUSION: Breast abscess is a fairly common surgical problem among both lactational and non-lactational females. Besides aerobes non-lactating breast abscesses also showed the presence of anaerobic bacteria. As minimally invasive management of breast abscesses, such as ultrasound guided drainage with systemic antibiotic drug therapy is the treatment of choice it is essential to provide the appropriate empirical antibiotic therapy in this drug resistance era.