Postpartum Mastitis and Community-acquired Methicillin-resistant Staphylococcus aureus
Open accessAbstract
This single-center, case-control study documents a relative increase in methicillin resistance among 48 cases of Staphylococcus aureus-associated postpartum mastitis during 1998-2005. Of 21 cases with methicillin resistance, 17 (81%) occurred in 2005. Twenty (95%) isolates contained the Staphylococcus cassette chromosome mec type IV gene; this suggests that the increase is due to community-acquired methicillin-resistant S. aureus.
AI snapshot
Written from the paper’s full text.
TL;DR
This single-center retrospective case-control study found a relative increase in methicillin-resistant *Staphylococcus aureus* (MRSA) among *S. aureus*–associated postpartum mastitis (PPM) cases from 1998–2005, with most MRSA isolates carrying SCC*mec* type IV, suggesting community-acquired MRSA. MRSA and MSSA PPM cases had broadly similar demographics, symptoms, and outcomes, but MRSA patients were less likely to receive timely effective antimicrobial coverage.
Key findings
- Among 48 *S. aureus*–associated PPM cases, 21 were MRSA and 27 were MSSA; 17 of 21 (81%) MRSA cases occurred in 2005, and a relative increase in MRSA PPM was noted over the study period (p = 0.04).
- Of 21 MRSA isolates available for PCR, 20 (95%) possessed SCC*mec* type IV; the remaining isolate contained SCC*mec* type II and was clindamycin resistant.
- MRSA and MSSA patients did not differ significantly in age, pregnancy history, symptoms, or most potential risk factors; however, MRSA patients were less likely to undergo incision and drainage (1 [6%] vs. 9 [41%], OR 0.09, 95% CI 0.00–0.84, p = 0.01).
- Among inpatients, MRSA patients were more likely to have temperature >38.1°C (6 [60%] vs. 2 [18%], OR 6.75, 95% CI 0.69–88.48, p = 0.05). Median time to effective MRSA coverage was 5 days (range 0–16 days), and only 2 patients received effective coverage at therapy onset.
Methods
- Retrospective, case-control study at Northwestern University’s Prentice Women’s Hospital and affiliated Lynn Sage Comprehensive Breast Center, including all patients with wound, fluid, drainage, or breast milk cultures positive for *S. aureus* from January 1998 through December 2005.
- Case-patients had PPM with MRSA; control-patients had PPM with MSSA. Patients without evidence of mastitis or with a history of MRSA were excluded.
- MRSA isolates were analyzed by PCR-based multiplex assay for SCC*mec* types I–V. Categorical variables were compared using χ² or Fisher exact tests; continuous variables used Wilcoxon tests, and trend was assessed with Cochrane-Armitage test.
Limitations
- The paper states the study population is small, limiting generalizability; cases were identified by positive cultures, likely representing more severe or complicated infections; retrospective design limited thorough risk assessment; medical records may not capture CA-MRSA risk factors such as socioeconomic status, incarceration, or day care exposure; and assessing incidence would require prospective analysis.
- The text also makes evident that isolates were not subjected to pulsed-field gel electrophoresis molecular typing, household contacts’ charts were not reviewed, and the study was single-center.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
1 of 16 cited sources checked · 0 supported · 0 flagged · accuracy not yet measured
- Findingown data
Ninety-five percent of MRSA isolates with SCCmec type IV were clindamycin susceptible.
“In contrast, 95% of isolates with SCC mec IV were clindamycin susceptible.”
Quote in the paperNot a substantial claim - Findingown data
A relative increase in MRSA postpartum mastitis was noted in the later years of the study, with p = 0.04.
“A relative increase in MRSA PPM was noted in the later years of the study (Figure 1, p = 0.04).”
- Also stated in: § Abstract · boosted
“This single-center, case-control study documents a relative increase in methicillin resistance among 48 cases of Staphylococcus aureus–associated postpartum mastitis during 1998–2005.”
Quote in the paperSubstantial claim - Also stated in: § Abstract · boosted
- Findingown data
Women with MRSA were significantly less likely to receive adequate and timely antimicrobial drug treatment.
“In the current study, women with MRSA were significantly less likely to receive adequate and timely antimicrobial drug treatment, but consequences of this difference are unclear.”
Quote in the paperSubstantial claim - Findingown data
Medical record review of affected patients did not show transmission of Staphylococcus aureus to infants or other family members.
“Medical record review of affected patients did not show transmission of S. aureus to infants or other family members.”
Quote in the paperNot a substantial claim - Findingown data
Among hospitalized patients, MRSA patients were more likely to have fever than MSSA patients.
“Although these inpatients did not differ in duration of symptoms before admission, length of stay, or leukocyte count, MRSA patients were more likely to have fever.”
Quote in the paperNot a substantial claim
- Findingown data
Nearly twice as many MRSA-infected than MSSA-infected women were multiparous in this study (57% vs. 33%).
“Notably, nearly twice as many MRSA-infected than MSSA-infected women were multiparous in this study (57% vs. 33%, respectively).”
Quote in the paperSubstantial claim - Findingown data
Median duration of therapy for MRSA, documented in 8 of 12 effective regimens, was 19 days, with a range of 14-62 days.
“Median duration of therapy, documented in 8 of 12 effective regimens, was 19 days (range 14–62 days).”
Quote in the paperNot a substantial claim - Findingown data
In 17 of 21 MRSA cases, antibiotic use was documented.
“In 17 of 21 MRSA cases, antibiotic use was documented.”
Quote in the paperSubstantial claim - Findingown data
Of patients who underwent needle aspiration, 7 (41%) MRSA and 5 (23%) MSSA patients required repeat aspiration.
“Of these patients, 7 (41%) MRSA and 5 (23%) MSSA patients required repeat aspiration.”
Quote in the paperNot a substantial claim - Findingown data
Duration of therapy for MSSA postpartum mastitis, documented in 12 of 18 cases, was a median of 13.5 days, with a range of 9-27 days.
“Duration of therapy for MSSA PPM, documented in 12 of 18 cases, was a median of 13.5 days (range 9–27 days).”
Quote in the paperNot a substantial claim - Findingown data
MSSA patients were more likely to undergo breast abscess incision and drainage than MRSA patients.
“Although MSSA patients were more likely to undergo breast abscess incision and drainage than their MRSA counterparts, both methods are considered appropriate surgical interventions (14).”
Quote in the paperNot a substantial claim - Findingown data
MRSA and MSSA patients did not differ in potential risk factors for infection, including diabetes, group B β-hemolytic streptococcus colonization, artificial rupture of membranes, epidural anesthesia, vaginal lacerations, episiotomy, cesarean section, or intrapartum antibiotic use.
“In addition, MRSA and MSSA patients did not differ in terms of potential risk factors for infection, such as diabetes, group B β-hemolytic streptococcus colonization, artificial rupture of membranes, epidural anesthesia, vaginal lacerations, episiotomy, cesarean section, or intrapartum antibiotic use (Table).”
Quote in the paperSubstantial claim - Findingown data
Median time to effective coverage for MRSA was 5 days, with a range of 0-16 days.
“Median time to effective coverage for MRSA was 5 days (range 0–16 days);”
Quote in the paperNot a substantial claim - Findingown data
Twenty (95%) of 21 MRSA isolates contained the Staphylococcus cassette chromosome mec type IV gene.
“Of 21 MRSA isolates available for PCR analysis, 20 possessed SCC mec IV.”
- Also stated in: § Abstract · plain
“Twenty (95%) isolates contained the Staphylococcus cassette chromosome mec type IV gene”
Quote in the paperSubstantial claim - Also stated in: § Abstract · plain
- Findingown data
Of 21 MRSA postpartum mastitis cases, 17 (81%) occurred in 2005.
“Of 21 cases with methicillin resistance, 17 (81%) occurred in 2005.”
Quote in the paperSubstantial claim - Findingown data
Among 17 MRSA-infected mothers in 2005, delivery dates spanned more than 9 months without overlap.
“Among 17 MRSA-infected mothers in 2005, delivery dates spanned >9 months without overlap”
Quote in the paperSubstantial claim - Findingown data
MRSA and MSSA patients did not differ significantly with respect to age, pregnancy history, or symptoms at the time of initial evaluation.
“MRSA and MSSA patients did not differ significantly with respect to age, pregnancy history, or symptoms at the time of initial evaluation.”
Quote in the paperNot a substantial claim - Interpretationreasoning
Mothers with young children may be at increased risk for community-acquired MRSA postpartum mastitis.
“therefore, mothers with young children may be at increased risk for CA-MRSA PPM.”
Quote in the paperSubstantial claim - Interpretationown data
PCR results suggest that 16 (94%) of MRSA isolates in 2005 were community-acquired.
“PCR results suggest that 16 (94%) of MRSA isolates in 2005 were community-acquired.”
Quote in the paperSubstantial claim- Rests on an assumption: SCCmec type IV is commonly associated with community-acquired infection.
- Interpretationown data
MRSA was independently acquired rather than outbreak-related.
“which suggests that MRSA was independently acquired rather than outbreak-related.”
Quote in the paperSubstantial claim - Premisecitation
Several authors have reported mother-to-infant transmission of MRSA through breast milk.
“Several authors have reported mother-to-infant transmission of MRSA through breast milk (15,16).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [15] Kawada, 2003, Transmission of Staphylococcus aureus between healthy, lactating mothers and their infants by breastfeeding., J Hum Lact source
- cites [16] Behari, 2004, Transmission of methicillin-resistant Staphylococcus aureus to preterm infants through breast milk., Infect Control Hosp Epidemiol source
- Interpretationown data
The increase in MRSA postpartum mastitis is due to community-acquired MRSA.
“this suggests that the increase is due to community-acquired methicillin-resistant Staphylococcus aureus.”
- Also stated in: § Conclusions · hedged
“Our study suggests that CA-MRSA is an increasingly common pathogen in spontaneous cases of PPM.”
- Also stated in: § Conclusions · hedged
“PPM due to CA-MRSA appears to be increasing at our institution.”
Quote in the paperSubstantial claim- Rests on an assumption: SCCmec type IV is commonly associated with community-acquired infection.
- Also stated in: § Conclusions · hedged
- Premisecitation
Reports of methicillin-resistant Staphylococcus aureus postpartum mastitis among young, healthy women lacking traditional risk factors for MRSA have emerged in the past few years.
“Reports of methicillin-resistant S. aureus (MRSA) PPM among young, healthy women lacking traditional risk factors for MRSA have emerged in the past few years (6,7).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [6] Saiman, 2003, Hospital transmission of community-acquired methicillin-resistant Staphylococcus aureus among postpartum women., Clin Infect Dis source
- cites [7] Laibl, 2005, Clinical presentation of community-acquired methicillin-resistant Staphylococcus aureus in pregnancy., Obstet Gynecol source
- Premisecitation
Decolonization measures in MRSA-colonized patients have not demonstrated long-term effectiveness.
“Although decolonization measures in MRSA-colonized patients have not demonstrated long-term effectiveness (17),”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Loveday, 2006, A systematic review of the evidence for interventions for the prevention and control of meticillin-resistant Staphylococcus aureus (1996–2004): report to the Joint MRSA Working Party (Subgroup A)., J Hosp Infect source
- Interpretationown data
The MRSA isolate from the perirectal abscess with identical susceptibilities suggests persistent colonization.
“which suggests persistent colonization; however, typing of the isolates was not performed.”
Quote in the paperNot a substantial claim
- Classified as probably not a substantial claim. 12
- May combine two claims. 15
Classified as probably not a substantial claim.
PremisecitationRisk factors associated with skin and soft tissue infections due to community-acquired MRSA have been described.
“Although risk factors associated with skin and soft tissue infections due to CA-MRSA have been described (8,9), characteristics unique to patients with CA-MRSA PPM are unknown.”
Quote in the paperSubstantial claim1 of 2 sources checked- cites [8] Naimi, 2003, Comparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infection., JAMA source
- cites [9] Charlebois, 2004, Origins of community strains of methicillin-resistant Staphylococcus aureus., Clin Infect Dis source
The Risk factors for multidrug-resistant S. aureus section identifies homelessness, injection drug use, and year of culture as factors associated with community MRSA. The Genotypes of community-acquired MRSA section mentions treatment for skin or soft-tissue infections, but the paper does not establish risk factors specifically for those infections due to CA-MRSA. Page numbers were not available in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measured
May combine two claims.
Findingown dataTen (48%) MRSA and 11 (41%) MSSA patients required hospitalization.
“Ten (48%) MRSA and 11 (41%) MSSA patients required hospitalization.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataTwelve MRSA patients received antibiotics effective against MRSA, but only 2 received effective coverage at therapy onset.
“Twelve patients received antibiotics effective against MRSA, but only 2 received effective coverage at therapy onset (both received clindamycin).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAntimicrobial agent use was documented for 18 of 27 MSSA cases; in all 18 cases, isolates were susceptible to the initial antibiotic of choice.
“Antimicrobial agent use was documented for 18 of 27 MSSA cases; in all 18 cases, isolates were susceptible to the initial antibiotic of choice.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataMost women in this study underwent incision and drainage or wound aspiration without significant differences in outcomes.
“Indeed, most women in this study underwent incision and drainage or wound aspiration without significant differences in outcomes.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataForty-six study patients had an abscess associated with mastitis; most (39 patients) underwent needle aspiration.
“Forty-six study patients had an abscess associated with mastitis; most (39 patients) underwent needle aspiration.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataOne patient in each group required readmission for recurrent symptoms.
“One patient in each group required readmission for recurrent symptoms (Table).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataDuring 1998-2005 at a single institution, 48 cases of Staphylococcus aureus-associated postpartum mastitis were identified; 21 were MRSA and 27 were MSSA.
“Forty-eight cases of S. aureus–associated PPM were identified during the study period; 21 cases were due to MRSA and 27 cases were due to MSSA.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn one MRSA patient, a perirectal abscess developed 5 months after the mastitis resolved, and intraoperative cultures of the abscess grew MRSA with identical susceptibilities.
“In 1 MRSA patient, a perirectal abscess developed 5 months after the mastitis resolved. Intraoperative cultures of the abscess grew MRSA with identical susceptibilities”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataNine MSSA patients underwent incision and drainage a median of 4.5 days after aspiration, whereas only 1 MRSA patient required subsequent débridement 1 day later.
“Notably, 9 MSSA patients underwent incision and drainage a median of 4.5 days after aspiration (range 0–17 days), whereas only 1 MRSA patient required subsequent débridement (1 day later).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe remaining MRSA isolate contained SCCmec type II and displayed resistance to clindamycin.
“The remaining isolate contained SCC mec II (Figure 2) and displayed resistance to clindamycin.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationStaphylococcus aureus is the most common bacterium isolated from breast milk cultures in postpartum mastitis, representing 37%-50% of isolates.
“S. aureus is the most common bacterium isolated from such cultures, representing 37%–50% of isolates (4,5).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [4] Marshall, 1975, Sporadic puerperal mastitis: an infection that need not interrupt lactation., JAMA source
- cites [5] Niebyl, 1978, Sporadic (non-epidemic) puerperal mastitis., J Reprod Med
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationGrowth of potentially pathogenic bacteria such as β-hemolytic streptococci or Staphylococcus aureus in breast milk cultures is associated with longer time to recovery and more frequent abscess formation.
“Although breast milk cultures are not routine in PPM management, the growth of potentially pathogenic bacteria (such as β-hemolytic streptococci or Staphylococcus aureus) is associated with longer time to recovery and more frequent abscess formation (3).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [3] Osterman, 2000, Lactation mastitis: bacterial cultivation of breast milk, symptoms, treatment, and outcome., J Hum Lact source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationIncision and drainage and wound aspiration are both considered appropriate surgical interventions for breast abscess.
“both methods are considered appropriate surgical interventions (14).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [14] Dener, 2003, Breast abscesses in lactating women., World J Surg source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationCommunity-acquired MRSA isolates remain susceptible to multiple non-β-lactam antibiotics and possess distinct molecular features.
“Isolates in these cases of community-acquired infection (CA-MRSA) remain susceptible to multiple non–β-lactam antibiotics and possess distinct molecular features (8).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [8] Naimi, 2003, Comparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infection., JAMA source
May combine two claims.
PremisecitationThe prevalence of community-acquired MRSA is increasing among young children, and intrafamilial transmission of isolates has been documented.
“The prevalence of CA-MRSA is increasing among young children, and intrafamilial transmission of isolates has been documented (11,12);”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [11] Herold, 1998, Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposed risk., JAMA source
- cites [12] Jones TF, Creech CB, Erwin P, Baird SG, Woron AM, Schaffner W. Family outbreaks of invasive community-associated methicillin-resistantStaphylococcus aureusinfection [cited 2006 Dec 26]. Clin Infect Dis [serial online]. 2006 Mar. Available from http://www.journals.uchicago.edu/CID/journal/issues/v42n9/38813/38813.web.pdf source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationPostpartum mastitis occurs in as many as one third of breastfeeding women in the United States and leads to breast abscess formation in approximately 10% of cases.
“Postpartum mastitis (PPM) occurs in as many as one third of breastfeeding women in the United States and leads to breast abscess formation in ≈10% of cases (1,2).”
Quote in the paperNot a substantial claim0 of 2 sources checkedClassified as probably not a substantial claim. May combine two claims.
Study design and conductreasoningAlthough the study results suggest a recent increase in MRSA postpartum mastitis, an assessment of incidence would require further prospective analysis.
“Finally, although the study results suggest a recent increase in MRSA PPM, an assessment of incidence would require further prospective analysis.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductreasoningPatients were added to the study by using results of positive cultures; consequently, cases likely represented more severe and complicated infections in which cultures were necessary after routine therapeutic measures failed.
“Second, patients were added to the study by using results of positive cultures; consequently, cases likely represented more severe and complicated infections in which cultures were necessary after routine therapeutic measures failed.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe study population is small, which limits the generalizability of the results.
“First, the study population is small, which limits the generalizability of the results.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenMedical record review may not indicate certain CA-MRSA risk factors, such as socioeconomic status, history of incarceration, or exposure to day care facilities.
“In addition, medical record review may not indicate certain CA-MRSA risk factors, such as socioeconomic status, history of incarceration, or exposure to day care facilities.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductreasoningA thorough risk assessment is limited by the retrospective study design.
“Third, although PPM has been associated with multiple patient factors (i.e., difficulty breastfeeding, tobacco use, and stress), a thorough risk assessment is limited by retrospective study.”
Quote in the paperSubstantial claim
The paper relies on this without support.
Characteristics unique to patients with community-acquired MRSA postpartum mastitis are unknown.
“characteristics unique to patients with CA-MRSA PPM are unknown.”
The paper relies on this without support.
SCCmec type IV is commonly associated with community-acquired infection.
“which is commonly associated with community-acquired infection.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Reddy's study showed that the cessation of breastfeeding rate after mastitis in the MRSA group was 16% and that in the MSSA group was 22%, without a statistical significance.
“However, Reddy’s study [13] showed a different result. Their study showed that the cessation of breastfeeding rate after mastitis in the MRSA group was 16% and that in the MSSA group was 22%, without a statistical significance.”
From Clinical characteristics of lactational breast abscess caused by methicillin-resistant Staphylococcus aureus: hospital-based study in China (2021) · cites this paper as [13]
Breastfeeding can still be continued in patients with MRSA-infected breast abscesses during lactation.
“Therefore, breastfeeding can still be continued in patients with MRSA-infected breast abscesses during lactation [13, 15].”
From Clinical characteristics of lactational breast abscess caused by methicillin-resistant Staphylococcus aureus: hospital-based study in China (2021) · cites this paper as [13]
The Study reports treatment of breast abscesses but does not say whether affected women continued breastfeeding. The Conclusions note possible MRSA transmission through breast milk and call for further study of its consequences for infants; they do not recommend either continuing or stopping breastfeeding with an MRSA-infected abscess. Searches for breastfeeding continuation and interruption found no such guidance in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
MSSA breastfeeding-discontinuation percentage is misstated
MinorThe footnote gives 24 MSSA patients with data for this row. Five of 24 is 21% to the nearest whole percent, not 22%.
Reported 22 · recomputed 20.833333
“Breastfeeding discontinued¶ | 3 (16) | 5 (22) | 0.71 (0.10–4.38) | 0.67”
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“In fact, widespread use of broad spectrum antibiotics is leading to increasing rates of antimicrobial resistance among mastitis-causing agents [27-29].”
BackgroundMastitis, Breast Abscess, and Granulomatous Mastitis
Omranipour, R., & Vasigh, M. (2020) · Advances in experimental medicine and biology · doi:10.1007/978-3-030-41596-9_7 · Cited by 63 · see citing works
ABM Clinical Protocol #4: Mastitis
The Academy of Breastfeeding Medicine Protocol Committee (2008) · Breastfeeding Medicine · doi:10.1089/bfm.2008.9993 · Cited by 51 · see citing works
Risk Factors for Staphylococcus aureus Postpartum Breast Abscess
Branch‐Elliman, W., Golen, T. H., Gold, H. S., Yassa, D. S., Baldini, L. M., & Wright, S. B. (2011) · Clinical Infectious Diseases · doi:10.1093/cid/cir751 · Cited by 49 · see citing works
“In recent years, MRSA has emerged as a significant cause of breast abscess, both in postpartum mothers and in the general population [7, 8, 15],”
BackgroundBanqué‐Navarro, M., Huttner, B. D., & Harbarth, S. (2008) · Current Opinion in Infectious Diseases · doi:10.1097/qco.0b013e3283013add · Cited by 43 · see citing works
Epidemiologic and Economic Effect of Methicillin-Resistant Staphylococcus aureus in Obstetrics
Beigi, R. H., Bunge, K. E., Song, Y., & Lee, B. Y. (2009) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e3181a116e4 · Cited by 43 · see citing works
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Health and Economic Burden of Post-Partum Staphylococcus aureus Breast Abscess
Branch‐Elliman, W., Lee, G. M., Golen, T. H., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0073155 · Cited by 32 · see citing works
“aureus (MRSA) have increased in the pregnant and post-partum population [10,11,12].”
BackgroundRole of sortase A in the pathogenesis ofStaphylococcus aureus-induced mastitis in mice
Chen, F., Liu, B., Wang, D., Wang, L., Deng, X., Bi, C., Xiong, Y., Wu, Q., Cui, Y., Zhang, Y., et al. (2013) · FEMS Microbiology Letters · doi:10.1111/1574-6968.12354 · Cited by 32 · see citing works
“aureus (MRSA) has emerged as an increasingly important pathogen of breast abscesses, both in postpartum mothers and in the general population (Moazzez et al., 2007; Reddy et al., 2007; Stafford et al., 2008).”
BackgroundInfluentialMastitis and Methicillin-Resistant Staphylococcus Aureus (MRSA): The Calm Before the Storm?
Schoenfeld, E. M., & McKay, M. P. (2009) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2008.11.021 · Cited by 31 · see citing works
Changchien, C., Chen, S.-W., Chen, Y.-Y., & Chu, C. (2016) · BMC Infectious Diseases · doi:10.1186/s12879-016-1630-z · Cited by 30 · see citing works
“Compared with MSSA infections, MRSA infections may present with different clinical characteristics and outcomes for deep-seated infections, bacteremia, catheter-related infections, and mastitis [24–26].”
BackgroundTransmission of Infectious Diseases Through Breast Milk and Breastfeeding
Lawrence, R. M. (2010) · Elsevier eBooks · doi:10.1016/b978-1-4377-0788-5.10013-6 · Cited by 32 · see citing works
Jiménez, E., Manzano, S., Schlembach, D., Arciszewski, K., Martı́n, R., Amor, K. B., Roelofs, M., Knol, J., Rodríguez, J. M., Abou‐Dakn, M., et al. (2021) · Microorganisms · doi:10.3390/microorganisms9091933 · Cited by 29 · see citing works
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“Methicillin-resistant Staphylococcus aureus (MRSA) have been reported to be an increasingly common cause of post-partum mastitis [1, 2].”
BackgroundClinical implications of methicillin-resistant Staphylococcus aureus in pregnancy
Beigi, R. H. (2010) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0b013e328342b719 · Cited by 21 · see citing works
Puerperal mastitis requiring hospitalization during a nine-year period
Lee, I.-W., Kang, L., Hsu, H., Kuo, P., & Chang, C. (2010) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2010.05.012 · Cited by 18 · see citing works
Antimicrobial susceptibility of bacteria isolated from cows with mastitis in 2006-2007
Malinowski, E., Lassa, H., Smulski, S., et al. (2008) · Cited by 18 · see citing works
Staphylococcus aureus metal acquisition in the mastitic mammary gland
Carlson, S. K., Erickson, D. L., & Wilson, E. (2020) · Microbial Pathogenesis · doi:10.1016/j.micpath.2020.104179 · Cited by 17 · see citing works
Li, Y., Ma, X.-J., & He, X.-P. (2021) · International Breastfeeding Journal · doi:10.1186/s13006-021-00429-6 · Cited by 16 · see citing works
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Infectious Mastitis During Lactation
Rodríguez, J. M., & Fernández, L. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-802725-7.00015-4 · Cited by 15 · see citing works
Staphylococcus Infections in Pregnancy
Kriebs, J. M. (2016) · The Journal of Perinatal & Neonatal Nursing · doi:10.1097/jpn.0000000000000165 · Cited by 14 · see citing works
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Abramov, V. M., Kosarev, I. V., Валериевич, М. А., Priputnevich, T. V., Deryusheva, E. I., Леонидовна, Н. Е., Chikileva, I. O., Abashina, T. N., Панин, А. Н., Melnikov, V. G., et al. (2023) · Antibiotics · doi:10.3390/antibiotics12030471 · Cited by 13 · see citing works
“aureus is the main etiological agent of acute mastitis [67,68] but more frequently causes subclinical infections that tend to become chronic and difficult to eradicate with conventional anti-microbial therapies [69].”
BackgroundPleasant, V. A. (2022) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0000000000000719 · Cited by 12 · see citing works
Diabetes and early postpartum methicillin-resistant Staphylococcus aureus infection in US hospitals
Parriott, A. M., & Arah, O. A. (2013) · American Journal of Infection Control · doi:10.1016/j.ajic.2012.10.011 · Cited by 12 · see citing works
Pérez, A., Orta, L., Padilla, E., et al. (2013) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.3109/14767058.2013.766700 · Cited by 11 · see citing works
“For instance, some studies have reported an association with multiparity, which in turn could be linked to the number of young children in a household, a plausible risk factor for intrafamilial crosstransmission [2,3].”
BackgroundResultInfluentialMRSA Breast Abscesses in Postpartum Women
Chuwa, E. W. L., Wong, C., Tan, Y. Y., & Hong, G. S. (2009) · Asian Journal of Surgery · doi:10.1016/s1015-9584(09)60010-5 · Cited by 9 · see citing works
Mastitis infecciosas durante la lactancia: un problema infravalorado (y II)
Jiménez, E., Delgado, S. F., Arroyo, R. G., et al. (2009) · Acta pediátrica española/Acta pediátrica española · Cited by 8 · see citing works
Methicillin‐Resistant Staphylococcus aureus Infection in the Obstetric Setting
Kriebs, J. M. (2008) · Journal of Midwifery & Women s Health · doi:10.1016/j.jmwh.2008.02.001 · Cited by 7 · see citing works
Skin and Soft Tissue Infections
Stryjewski, M. E., Nannini, E. C., & Corey, G. R. (2009) · Wiley eBooks · doi:10.1002/9781444308464.ch19 · Cited by 7 · see citing works
Infectious Diseases in Pregnancy
Kriebs, J. M. (2008) · The Journal of Perinatal & Neonatal Nursing · doi:10.1097/01.jpn.0000333922.07458.e0 · Cited by 6 · see citing works
Prevalence and Antibiotic Susceptibility of Streptococcus spp. in Cows with Mastitis in Germi, Iran
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Inadequate research on methicillin-resistantStaphylococcus aureusrisk among postpartum women
Parriott, A. M., Chow, A. L., & Arah, O. A. (2013) · Expert Review of Anti-infective Therapy · doi:10.1586/14787210.2013.850027 · Cited by 6 · see citing works
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Antibiotic safety considerations in methicillin-resistant Staphylococcus aureus postpartum mastitis
Farahnik, B., & Murase, J. E. (2016) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2016.04.042 · Cited by 5 · see citing works
Community-Associated MRSA Infections in Women
Harris, A. L., & Fantasia, H. C. (2010) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2010.02.023 · Cited by 5 · see citing works
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Antonello, V. S., Dallé, J., Jiménez, M. F., Tramontini, P., & Reginatto, A. G. (2024) · Revista Brasileira Ginecologia e Obstetrícia · doi:10.61622/rbgo/2024rbgo34 · Cited by 4 · see citing works
“(5,13) Considering resistance to oxacillin, tendency of susceptibility for these and other antibiotics in clinical practice.”
BackgroundMedical Complications of Mothers
Lawrence, R. A., & Lawrence, R. M. (2010) · Elsevier eBooks · doi:10.1016/b978-1-4377-0788-5.10016-1 · Cited by 3 · see citing works
CA-MRSA: Epidemiology of a Pathogen of a Great Concern
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“There are frequent reports of the spread of CA-MRSA among men who have sex with men, soldiers, athletes, intravenous illicit drug users, prisoners, people with compromised skin and mucous membranes, poor hygiene, postpartum mastitis (Reddy et al., 2007), Native Americans from the U.”
BackgroundLee, I.-W., Kang, L., Kuo, P., & Chang, C. (2011) · Taiwanese Journal of Obstetrics and Gynecology · doi:10.1016/j.tjog.2011.01.009 · Cited by 1 · see citing works
“Recently, oxacillin-resistant S aureus (ORSA) has been reported to be the main pathogen in puerperal mastitis [2].”
BackgroundArshi, S., Shafiq, S., Thakur, N., Amin, M., Masoodi, T., & Khurshid, S. (2021) · IP International Journal of Medical Microbiology and Tropical Diseases · doi:10.18231/j.ijmmtd.2020.046 · Cited by 1 · see citing works
(2010) · Elsevier eBooks · doi:10.1016/b978-1-4377-0788-5.10034-3 · Cited by 1 · see citing works
Clinical mastitis in breastfeeding women: study of 56 cases
Tena, D., López‐Garrido, B., & Losa, C. (2016) · Scandinavian Journal of Infectious Diseases · doi:10.1080/23744235.2016.1204662 · Cited by 1 · see citing works
“aureus has been considered the main aetiological agent of acute mastitis.[6] However, we here found a low percentage of cases caused by S.”
BackgroundShould we be afraid of methicillin-resistant Staphylococcus aureus in obstetrics?
Kufelnicka-Babout, M. (2013)
Hansen, W. F. (2010) · doi:10.1002/9781444323870.ch44
(2021) · Elsevier eBooks · doi:10.1016/b978-0-323-68013-4.00080-8
Đánh giá hiệu quả của chọc hút áp xe vú dưới hướng dẫn siêu âm ở phụ nữ cho con bú
Nguyễn, V. T. (2022) · Vietnamese Journal of Radiology and Nuclear Medicine · doi:10.55046/vjrnm.42.42.2021
MASTITIS IN LACTATING PATIENTS - A LITERATURE REVIEW
Krzewska, K., Floriańczyk, A., Romanowicz, E., Kołdyj, A., Ozdarska, A., Biernat, A. K., Lampart, M., Rupińska, A., Skarakhodava, H., & Kozon, K. (2025) · International Journal of Innovative Technologies in Social Science · doi:10.31435/ijitss.3(47).2025.3491 · Cited by 1 · see citing works
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“Breast necrosis may require surgical debridement and advanced wound care, such as negative pressure wound therapy (NPWT) 9,10) .”
Sony, S., & Sahira, H. (2025) · Reviews in Medical Microbiology · doi:10.1097/mrm.0000000000000453
Growth of Klebsiella pneumoniae from a recurrent non-lactational breast abscess
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Ratheesh, M., Jose, S. P., Sreevallabhan, S., et al. (2026) · Journal of Molecular Histology · doi:10.1007/s10735-026-10953-6
“Keywords Ethnopharmacology · Mastitis · S. aureus · NAGase · TLR-2 · NOX-2 industry (Algharib et al. 2020; Reddy et al. 2007).”
Stafford, I., Hernandez, J., Laibl, V., Sheffield, J., Roberts, S., & Wendel, G. (2008) · Obstetrics & Gynecology · doi:10.1097/aog.0b013e31818187b0 · Cited by 62 · see citing works
Puerperal mastitis in the past decade: results of a single institution analysis
Lukassek, J., Ignatov, A., Faerber, J., Costa, S. D., & Eggemann, H. (2019) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-019-05333-3 · Cited by 16 · see citing works
“, CAMRSA was not a crucial causative organism for puerperal mastitis in our population [3, 12], Our results showed, that MRSA did not have the same significance as a pathogen for mastitis compared to data obtained by Stafford et al.”
Result
- Authors
- Reddy, P., Qi, C., Zembower, T., Noskin, G. A., & Bolon, M.
- Affiliations
- Northwestern University (US)
- Venue
- Emerging Infectious Diseases
- Published
- 2007-02
- Volume
- 13
- Issue
- 2
- Pages
- 298-301
- ISSN
- 1080-6040 (ISSN-L)
- 1080-6059
- PMC
- PMC2725877
- OpenAlex
- W2060238548
- Semantic Scholar
- 0d83c7439cc2c9d1e8de5ab4dd14efd76c689cd9
- Cited by
- 69
- References
- 18
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 3 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 5 · 2014: 5 · 2013: 7 · 2012: 3
- FWCI
- 4.31
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Emerging infectious diseases (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (submittedVersion)
- PubMed Central (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Northwestern University
- Feinberg School of Medicine
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Life Sciences › Agricultural and Biological Sciences › Agronomy and Crop Science › Milk Quality and Mastitis in Dairy Cows
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Keywords
- postpartum mastitis, methicillin-resistant Staphylococcus aureus, community-acquired MRSA, antimicrobial resistance trends
- MeSH terms
- Adult, Female, Humans, Mastitis, Retrospective Studies, Staphylococcal Infections, Staphylococcus aureus, Case-Control Studies, Methicillin Resistance, Community-Acquired Infections, Postpartum Period
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