Volume 13, Number 2—February 2007
Dispatch
Postpartum Mastitis and Community-acquired Methicillin-resistant Staphylococcus aureus
Pavani Reddy*
, Chao Qi*, Teresa Zembower*, Gary A. Noskin*, and Maureen Bolon*
, Chao Qi*, Teresa Zembower*, Gary A. Noskin*, and Maureen Bolon*Table
Demographics, symptoms, interventions, and outcomes in patients with Staphylococcus aureus–associated postpartum mastitis*
| Variable | No. (%) patients | OR (95% CI) | p value* | |
|---|---|---|---|---|
| MRSA (n = 21) | MSSA (n = 27) | |||
| Demographics | ||||
| Median age, y | 32 | 32.5 | – | 0.90 |
| Multiparous | 12 (57) | 9 (33) | 2.67 (0.71–10.4) | 0.10 |
| Race† | ||||
| Caucasian | 15 (71) | 19 (79) | 0.66 (0.13–3.19) | 0.55 |
| Other | 6 (29) | 5 (21) | 1.52 (0.31–7.59) | 0.55 |
| Clinical symptoms | ||||
| Fever | 7 (33) | 10 (37) | 0.85 (0.22–3.30) | 0.79 |
| Skin changes or fissures | 6 (29) | 8 (30) | 0.95 (0.23–3.96) | 0.94 |
| Induration | 20 (95) | 21 (78) | 5.71 (0.59–275.7) | 0.09 |
| Median time from delivery to symptom onset, d | 27 | 33.5 | – | 0.60 |
| Prenatal risk factors | ||||
| Diabetes | 2 (10) | 1 (4) | 2.74 (0.13–167.56) | 0.41 |
| Group B β-hemolytic streptococcus colonization‡ | 3 (16) | 4 (16) | 0.88 (0.11–5.96) | 0.87 |
| Intrapartum risk factors | ||||
| Intrapartum treatment with antimicrobial drugs† | 9 (43) | 7 (29) | 1.82 (0.45–7.52) | 0.34 |
| Cesarean section‡ | 3 (14) | 2 (8) | 1.92 (0.19–24.89) | 0.50 |
| Artificial rupture of membranes§ | 12 (63) | 10 (44) | 2.23 (0.54–9.41) | 0.20 |
| Vaginal laceration or episiotomy§ | 18 (95) | 22 (96) | 0.82 (0.01–67.75) | 0.89 |
| Epidural anesthesia§ | 12 (63) | 18 (78) | 0.48 (0.10–2.26) | 0.28 |
| Interventions | ||||
| Aspiration | 17 (81) | 22 (82) | 0.97 (0.18–5.66) | 0.96 |
| Repeat aspiration | 7 (41) | 5 (23) | 2.38 (0.48–12.14) | 0.22 |
| Incision and drainage | 1 (6) | 9 (41) | 0.09 (0.00–0.84) | 0.01 |
| Drain placement | 3 (14) | 6 (22) | 0.58 (0.08–3.26) | 0.49 |
| Outcomes | ||||
| Hospital admission | 10 | 11 | 1.32 (0.36–4.90) | 0.63 |
| Median length of stay, d | 4 | 4 | – | 0.90 |
| Median leukocyte count, cells/μL | 12.8 | 15.3 | – | 0.21 |
| Temperature >38.1°C | 6 (60) | 2 (18) | 6.75 (0.69–88.48) | 0.05 |
| Recurrent symptoms requiring readmission | 1 (10) | 1 (9) | 1.11 (0.01–95.83) | 0.94 |
| Outpatient, later admitted | 2 (18) | 1(6) | 3.75 (0.16–235.66) | 0.29 |
| Breastfeeding discontinued¶ | 3 (16) | 5 (22) | 0.71 (0.10–4.38) | 0.67 |
*MRSA, methicillin-resistant Staphylococcus aureus; MSSA, methicillin-susceptible S. aureus; OR, odds ratio for categorical variables using χ2 analysis or Fisher exact test where appropriate; CI, confidence interval; p values for continuous variables calculated by using the Wilcoxon test.
†Data available for 24 MSSA patients.
‡Data available for 25 MSSA patients.
§Data available for 19 MRSA and 23 MSSA patients.
¶Data available for 19 MRSA and 24 MSSA patients.
