The Role of in Mastitis : A Multidisciplinary Working Group Experience

Background: Breastfeeding women are at risk of developing mastitis during the lactation period. has emerged as the community-acquired pathogen responsible for virulence (methicillin resistance and Panton-Valentine leukocidin toxin producing).

Research Aim: The aim was to compare the microorganisms responsible for mastitis and breast abscesses during breastfeeding.

Methods: This observational study was conducted with a sample of women ( = 60) admitted to our hospital between 2016 and 2018. Participants affected by mastitis and breast abscess were studied and cared for by a multidisciplinary working group. A diagnostic breast ultrasound identified the pathology.

Results: Twenty-six participants (43.3%) were affected by mastitis and 34 (56.7%) by breast abscess. The most common microorganism identified was (; mastitis, = 13; abscesses, = 24). Methicillin resistance was identified in 21 (44.7%) strains: 17 (80.9%) cases of abscess and four (19.1%) cases of mastitis. The median number of months of breastfeeding was smaller in the methicillin-resistant (MRSA) cases (median = 3, range = 1-20 months) than in the methicillin-sensitive (MSSA) cases (median = 6.5, range = 3-21 months). The Panton-Valentine leukocidin toxin gene was detected in 12 (25.5%) cases (MRSA, = 8, 66.7%; MSSA, = 4, 33.3%). Hospitalization was required more frequently in MRSA ( = 8, 38%; five Panton-Valentine leukocidin positive) than in MSSA cases ( = 5, 19%; one Panton-Valentine leukocidin positive). Four women out of the eight MRSA cases (50%) that were Panton-Valentine leukocidin positive stopped breastfeeding during mammary pathologies, three (37.5%) participants continued breastfeeding until the follow-up recall, and one case was lost at follow-up.

Conclusion: Clinical severity was probably complicated by the presence of the Panton-Valentine leukocidin toxin, which required hospitalization more frequently.