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Antibiotic susceptibility of Staphylococcus, Streptococcus spp. and Gram-negative bacilli strains isolated from breast cancer patients with surgical site infection at the Department of Surgical Oncology, Medical University of Gdansk in Poland in 2012-2016.
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Background and Objectives: Surgical site infection (SSI) is a significant complication of non-reconstructive and reconstructive breast surgery. This study aimed to assess SSI after breast surgery over five years in a single center in Poland. The microorganisms responsible for SSI and their antibiotic susceptibilities were determined. Materials and...
Context in source publication
Context 1
... bacteria were responsible for the majority of infections (101, 72.1%), and most of the isolates (75, 53.6%) were Staphylococcus strains. The microorganisms responsible for SSI are presented in Figure 1 and Table 2. Table 3 shows the susceptibility of the isolated bacteria to antibiotics. Staphylococcus aureus strains, the most common etiological factor, were susceptible to all beta-lactam antibiotics (except penicillin) and exhibited 100% sensitivity to aminoglycosides, trimethoprim/sulfamethoxazole, linezolid, and vancomycin. ...Citations
... Although endoscopic breast surgery has a lower incidence of complications, including infection, skin burns, subcutaneous emphysema, intraoperative and postoperative bleeding, wound and ap necrosis [9,11,13], the rate is still reported between 1-35% for breast surgery in general [21]. The most common pathogen causing postoperative infections in breast surgery is Gram-positive bacteria, with Staphylococcus aureus, particularly methicillin-resistant strains, being the most common [21,22]. A review study showed that postoperative infections in endoscopic breast surgery are often related to implanted absorbable materials, with 7 out of 60 patients experiencing infections [9]. ...
Background Breast abscess is a common infectious disease of the breast, but a breast abscess caused solely by Peptoniphilus harei is extremely rare. Endoscopic breast-conserving surgery for breast cancer is an emerging breast surgical technique that is considered a clean surgery with a low postoperative infection rate.
Case Presentation We report a case of a patient who underwent endoscopic breast-conserving surgery for breast cancer and developed a breast abscess in the surgical area after radiotherapy. Bacterial culture and identification confirmed that the abscess was caused by P. harei infection. After treatment with antibiotics targeting P. harei and active wound debridement, the patient recovered well.
Conclusions This is the first reported case of a breast abscess caused solely by P. harei after endoscopic breast-conserving surgery for breast cancer. Early identification of the pathogen and targeted treatment are crucial for successful management.
... 11 Nevertheless, it is known that patients with a history of breast cancer surgery are more prone to surgical site infection due to chemotherapy and/or radiotherapy to which the tissues are subjected. 12 Moreover, it has been observed that oncologic and immunocompromised patients can have severe infections due to Aeromonas. 13 The aim of our paper was to report a new case of Aeromonas breast infection in a healthy patient with no risk factors who underwent a cosmetic surgery procedure. ...
Several strategies for the management of venous congestion of the nipple–areola complex (NAC) after reduction mammaplasty have been proposed. Among these, hirudotherapy represents an ancient but still effective method, even though the risk of infections related to leeches should be considered. We report a peculiar case of breast infection and sepsis after leech therapy in a patient who underwent a reduction mammaplasty. A prompt surgical debridement of the wounds and necrotic tissues associated with targeted antibiotic therapy led to a fast improvement of clinical conditions, and partial preservation of the NAC was obtained. Accurate knowledge of the clinical presentation of soft tissue infections related to leeching allows for an early diagnosis and would serve as a warning for surgeons who approach such breast cosmetic procedures.
... Notably, Staphylococcae, identified in acute and chronic wounds, were also associated with the SMI surface ( Figure 4). In aesthetic breast surgery, generally categorized as clean surgery, studies of postoperative surgical site infection (SSI) rate increase, commonly identified bacteria in these infections include Staphylococcus, Escherichia, Pseudomonas, Propionibacterium, and Corynebacterium [41,[90][91][92][93]. Of note, staphylococci are the most common axillary flora, and antibiotics targeting them do not significantly impact SSIs [36,94]. ...
Breast cancer is the most common cancer in women globally, often necessitating mastectomy and subsequent breast reconstruction. Silicone mammary implants (SMIs) play a pivotal role in breast reconstruction, yet their interaction with the host immune system and microbiome remains poorly understood. This study investigates the impact of SMI surface topography on host antimicrobial responses, wound proteome dynamics, and microbial colonization. Biological samples were collected from ten human patients undergoing breast reconstruction with SMIs. Mass spectrometry profiles were analyzed for acute and chronic wound proteomes, revealing a nuanced interplay between topography and antimicrobial response proteins. 16S rRNA sequencing assessed microbiome dynamics, unveiling topography-specific variations in microbial composition. Surface topography alterations influenced wound proteome composition. Microbiome analysis revealed heightened diversity around rougher SMIs, emphasizing topography-dependent microbial invasion. In vitro experiments confirmed staphylococcal adhesion, growth, and biofilm formation on SMI surfaces, with increased texture correlating positively with bacterial colonization. This comprehensive investigation highlights the intricate interplay between SMI topography, wound proteome dynamics, and microbial transmission. The findings contribute to understanding host–microbe interactions on SMI surfaces, essential for optimizing clinical applications and minimizing complications in breast reconstruction.
... Notably, Staphylococcae, identified in acute and chronic wounds, were also associated with the SMI surface ( Figure 4). In aesthetic breast surgery, generally categorized as clean surgery, studies of postoperative surgical site infection (SSI) rate increase, commonly identified bacteria in these infections include Staphylococcus, Escherichia, Pseudomonas, Propionibacterium, and Corynebacterium (41,(78)(79)(80)(81). Of note, staphylococci are the most common axillary flora, and antibiotics targeting them do not significantly impact SSIs (36,82). ...
Breast cancer is the most common cancer in women globally, often necessitating mastectomy and subsequent breast reconstruction. Silicone mammary implants (SMIs) play a pivotal role in breast reconstruction, yet their interaction with the host immune system and microbiome remains poorly understood. This study investigates the impact of SMI surface topography on host antimicrobial responses, wound proteome dynamics, and microbial colonization. Biological samples were col-lected from ten human patients undergoing breast reconstruction with SMIs. Mass spectrometry profiles were analyzed for acute and chronic wound proteomes, revealing a nuanced interplay between topography and antimicrobial respondseproteins. 16S rRNA sequencing assessed mi-crobiome dynamics, unveiling topography-specific variations in microbial composition. Surface topography alterations influenced wound proteome composition. Microbiome analysis revealed heightened diversity around rougher SMIs, emphasizing topography-dependent microbial inva-sion. In vitro experiments confirmed staphylococcal adhesion, growth, and biofilm formation on SMI surfaces, with increased texture correlating positively with bacterial colonization. This comprehensive investigation highlights the intricate interplay between SMI topography, wound proteome dynamics, and microbial transmission. The findings contribute to understanding host-microbe interactions on SMI surfaces, essential for optimizing clinical applications and minimizing complications in breast reconstruction.
... MDR-MRSA isolates were identified in the current study in 62.5%, and no PDR and XDR isolated were detected. A study by Palubicka et al [29] documented that MRSA is responsible for up to 9.8% after BC surgery and it was not detected in any MDR, PDR, and XDR-MRSA isolates. Generally, there are not many studies on MDR-MRSA associated with BC infections, but there are investigations into MRSA with solid cancer such as Perdikouri et al 30 study that found 15 (21%) patients had infections with solid tumors due to MDR-MRSA, and mentioned that MDR-MRSA, caused significant mortality and serious infections and did so in most of the patients with sepsis or neutropenic fever which represents a worrying problem. ...
Breast cancer is the second most common cancer in females; therefore, the prevalence of multi-drug and methicillin-resistant Staphylococcus aureus may lead to increase mortality and morbidity rates among women with breast cancer. The present study aimed to identify the prevalence of multiple drug-resistant Staphylococcus aureus among breast cancer patients. From November (2019) to January (2020), 216 random patients with breast cancer enrolled in an oncology center in Babylon City, Iraq. Among the 130 Staphylococcus aureus isolates, 40 (30.7%) isolates carried the mecA gene using the polymerase chain reaction technique. 9 (22.5%), 5 (12.5%), 5 (12.5%), 3 (7.5%), and 3 (7.5%) of multi-drug and methicillin-resistant isolates were detected to be resistant to 3, 5, 6, 4 and 7 classes of antibiotics, respectively. Multiple antimicrobial resistance index values for multi-drug resistant isolates ranged from 0.3 to 0.6. In the current investigation, it was found that Staphylococcus aureus was the most common cause of infections associated with breast cancer, and the prevalence of multidrug-and methicillin-resistant Staphylococcus isolates is of concern because it may cause complications and may lead to death, as these bacteria possess high virulence characteristics such as resistance to β-lactams and multiple resistance to non-β-lactams. According to the findings the results of the current study and definitions of multiple drug resistance, the isolates of methicillin-resistant Staphylococcus aureus were multi-resistant isolates, but they did not possess extensive and pandrug resistance, because the isolates were resistant to at least three to seven classes of antibiotics, but there were no isolates resistant to most or all of the antibiotics.
... The rate of breast reconstruction surgery has increased in recent years, with implants being used in 50.0% of the procedures performed [2]. Despite the undoubted benefits of implant-based reconstruction, the procedure can be complicated by implant infections, which affect up to 15.0% of patients undergoing reconstruction [3][4][5]. The most common causative microorganism is Staphylococcus aureus, which has been shown to account for up to 49.0% of all isolated bacteria [6][7][8][9]. ...
... Infections occurred both in patients colonized and non-colonized with S. aureus. The SSI incidence of 5.3% after mastectomy with reconstruction is lower than 14.6%, as reported by Palubicka et al [5] in in their retrospective study in a single center in Poland, among patients who underwent subcutaneous amputation with reconstruction. Olsen et al [3] in their retrospective cohort study observed infections in 10.3% of patients after mastectomy and implant reconstruction. ...
Background
Despite the benefits of implant-based breast reconstruction in patients with breast cancer, the procedure can be complicated by surgical site infections (SSI). This study aimed to evaluate the association between nasal carriage of Staphylococcus aureus strains and the incidence of SSI among patients who underwent reconstructive procedures. We also assessed the ability of colonizing S. aureus strains to form biofilm.
Material/Methods
Medical data from 124 patients with 132 post-mastectomy breast reconstructions performed at the Oncology Center in Bydgoszcz, Poland, between June 2020 and August 2021 were analyzed. A 90-day incidence of SSI was found in 7/132 reconstructions (5.3%). The study group included 132 reconstructions, and was divided into those with infection (n=7) and without infection (n=125). Between-group differences were assessed using the t test for continuous variables and chi-square test for categorical variables. Biofilm formation among 32 S. aureus strains was determined by using quantitative and qualitative assays.
Results
There were no significant differences in relation to the patients’ S. aureus colonization status. Infections occurred both in patients colonized and not colonized with S. aureus. S. aureus nasal carriage did not affect the rate of SSI at 90 days after surgery. About 97.0% of the strains had a strong capacity for biofilm formation.
Conclusions
There was no association between nasal carriage of strains of S. aureus and the incidence of SSI. However, further investigations on a larger group of patients and longer observation time are needed to investigate this potential risk factor in detail.
... Generally, breast surgery is considered to be a clean surgery but the postoperative SSI rate rises by 2-2.9% in augmentation and is the most common cause of readmission [7,8]. The common organisms identified are Staphylococcus epidermidis and S. aureus, Escherichia, Pseudomonas, Propionibacterium, and Corynebacterium [9,10]. ...
Capsular contracture (CC) is one of the most common complications of implant-based breast reconstruction or augmentation surgery. Common risk factors of CC include biofilm, surgical site infections, history of prior CC or fibrosis, history of radiation therapy, and implant characteristics. Though bacterial contamination of breast protheses is associated with adverse sequelae, there are not universally accepted guidelines and limited best practice recommendations for antimicrobial breast pocket irrigation. Despite advanced molecular biology, the exact mechanism of this complication is not fully understood. Interventions that decrease the rate of CC include antibiotic prophylaxis or irrigation, acellular dermal matrix, leukotriene inhibitors, surgical techniques, and others. However, there is inconsistent evidence supporting these risk factors, and the current data was based on broad heterogeneous studies. The objective of this review was to provide a summary of the current data of contributing risk factors as well as preventative and treatment measures for CC.
Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266
... At rates ranging from 1% to 26% following breast surgeries due to breast cancer, SSIs are higher than the nationally reported incidence of what is expected for clean surgical procedures (Sattar et al., 2021). Post-discharge complications are higher with mastectomies (>100 K mastectomies annually in the United States) (Brigham and Women's Hospital, 2023), with tissue that had been subjected to radiotherapy or chemotherapy (Bratzler and Houck, 2004;Palubicka et al., 2019) and in the presence of risk factors such as obesity, diabetes, and smoking (Sadok et al., 2022). In addition to the high financial cost of follow-up care and potential readmission (Yu et al., 2020), recovery may be filled with fear, uncertainty, and distress -impacting quality of life and potentially resulting in unfavorable patient outcomes (Larsson et al., 2022). ...
Patient work in surgery recovery is fraught with complex judgments and decisions. These decisions are not unlike ones that professionals make that we traditionally study with the Naturalistic Decision Making (NDM) theoretical lens and methods. Similarly, patients are making decisions in naturalistic settings and doing so with the objective of minimizing risk and maximizing safety. What is different is that patients are put in a position to perform complex, high level, high consequence work in the absence of any training, education, or decision support. Using a lived experience, I illustrate that the burden of judgement and decision making in surgery recovery work (e.g., caring for surgical sites, managing drains, managing medications, supporting activities of daily living) can be understood through a macrocognitive paradigm. Thus, the NDM theoretical lens and the associated methods is appropriate to study this problem space.
... Nerve damage can be a reason for postoperative pain, motor defects and paresthesia. According to recent studies, surgical site infections were noted in 1.4% to 6.2% patients after breast surgery [23]. Wound infection and necrosis of mastectomy flaps can affect negatively wound healing [24]. ...
Introduction and purpose
Breast cancer (BC) management includes local therapies surgery, radiotherapy and systemic – hormonotherapy, chemotherapy, targeted and immunotherapy. However, some adverse events of these treatment strategies limit their wide administration in BC therapy. The aim of the study was to present adverse effects in the management of BC, prevention and treatment of them.
State of the knowledge
Surgery of the breast leads to lymphedema, pain, and anatomical changes. The most characteristic adverse event of radiotherapy is radiation dermatitis which is more probable among obese, older patients, females, and smokers. Other side effects are pneumonia, cardiac and pulmonary injury. Chemotherapeutics lead to complications such as anthracyclines-induced cardiotoxicity. As a consequence of endocrine therapy, patients are affected by vasomotor, musculoskeletal, and vulvovaginal symptoms. Immune checkpoint inhibitors may cause immune-related adverse events (irAEs), which are usually mild. When severe irAEs occur, immunosuppressive drugs are used. Depending on stage, toxicities of the therapies can lead to interrupting the treatment of BC. Moreover, drug resistance is an important therapeutic obstacle in BC treatment.
Conclusion
The application of a diversity of drugs in the treatment of breast cancer is associated with adverse effects which limit its efficacy. It is vital to develop novel, targeted therapeutic methods to optimize outcomes of patients. Given the adverse effects of breast cancer therapies and drug resistance, it is vital to develop novel, targeted therapeutic methods.
... The average national cost of all healthcare-related injuries was estimated to be up to USD 220 million annually [3]. Overall, worldwide incidence of SSI after breast surgery has been reported to vary between 2% and 30% [4][5][6]. Due to inherent variations in methods of data collection, it is difficult to extrapolate published data for useful comparisons. Therefore, in the absence of generally reliable and comparable SSI data, it is paramount for individual breast cancer units to establish their own data to drive infection prevention programs and maximise patient safety. ...
Background:
Surgical-site infections (SSIs) are the commonest cause of healthcare-related infections. Although a surgical care bundle (SCB), defined as a group of preventative measures, is effective in reducing SSIs, it has not been well documented in breast cancer surgery. We aimed to investigate the impact of SCB on SSI.
Methods:
A single-centre retrospective comparative cohort study between 2016 and 2020 was carried out. An SCB including eight different measures was implemented in October 2018 at Sahlgrenska University Hospital, Sweden. Patients who underwent non-reconstructive breast cancer surgery were included for analysis. The primary endpoint was SSI within 30 days after surgery.
Results:
Overall, 10.4% of patients (100/958) developed SSI. After SCB implementation, the overall SSI rate reduced from 11.8% to 8.9% (p = 0.15). The largest SSI rate reduction was seen in the subgroup that underwent breast conservation and sentinel lymph node biopsy (SLNB), from 18.8% to 9.8% (p = 0.01). In this multivariable analysis adjusting for patient and treatment factors, the implementation of SCB resulted in a statistically significant reduction in SSI risk (OR 0.63, 95% CI 0.40-0.99, p = 0.04).
Conclusions:
The implementation of a SCB could reduce the incidence of SSI in breast cancer surgery.
