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Volume 13, Number 2—February 2007
Dispatch

Postpartum Mastitis and Community-acquired Methicillin-resistant Staphylococcus aureus

Pavani Reddy*Comments to Author , Chao Qi*, Teresa Zembower*, Gary A. Noskin*, and Maureen Bolon*
Author affiliations: *Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA;

Main Article

Table

Demographics, symptoms, interventions, and outcomes in patients with Staphylococcus aureus–associated postpartum mastitis*

VariableNo. (%) 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.

Main Article

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