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Breaking the Barrier: A Study on Multi-drug Resistance in Breast Abscess at an Academic Malaysian Hospital

  • Surgery in Low and Middle Income Countries
  • Published:
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Abstract

Background

In recent years, the increase in antibiotics usage locally has led to a worrying emergence of multi-drug resistant organisms (MDRO), with the Malaysian prevalence rate of methicillin-resistant Staphylococcus aureus (MRSA) ranging from 17.2 to 28.1% between 1999 and 2017. A study has shown that 7% of all non-lactational breast abscesses are caused by MRSA. Although aspiration offers less morbidities compared to surgical drainage, about 20% of women infected by MRSA who initially underwent aspiration subsequently require surgical drainage. This study is conducted to determine the link between aetiology, antimicrobial resistance pattern and treatment modalities of breast abscesses.

Methods

Retrospective study of reviewing microbiology specimens of breast abscess patients treated at Universiti Malaya Medical Centre from 2015 to 2020. Data collected from microbiology database and electronic medical records were analysed using SPSS V21.

Result

A total of 210 specimens from 153 patients were analysed. One-fifth (19.5%) of the specimens isolated were MDRO. Lactational associated infections had the largest proportion of MDR in comparison to non-lactational and secondary infections (38.5%, 21.7%, 25.7%, respectively; p = 0.23). Staphylococcus epidermidis recorded the highest number of MDR (n = 12) followed by S. aureus (n = 8). Adjusted by aetiological groups, the presence of MDRO is linked to failure of single aspirations (p = 0.554) and significantly doubled the risk of undergoing surgical drainage for resolution (p = 0.041).

Conclusion

MDR in breast abscess should be recognised as an increasing healthcare burden due to a paradigm shift of MDRO and a rise of resistance cases among lactational associated infection that were vulnerable to undergo surgical incision and drainage for resolution.

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Acknowledgements

The authors have none to disclose.

Funding

The study was funded by the Malaysian Ministry of Higher Education through the Fundamental Research Grant Scheme (FRGS/1/2021/STG01/UCSI/03/1).

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Authors and Affiliations

  1. Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

    Choon Jiat Lee

  2. Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

    Lee Lee Lai

  3. Department of Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

    Velayuthan Rukumani Devi

  4. Breast Surgery Unit, Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

    Mee Hoong See & Yoke Kiet Doon

  5. Institute of Ocean and Earth Sciences, Universiti Malaya, Kuala Lumpur, Malaysia

    Phaik Eem Lim & Sze Wan Poong

  6. Department of Biotechnology, Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia

    Crystale Siew Ying Lim, Christina Shook Cheng Chong, Pui Yuei Lee & Yong Hui Tan

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  1. Choon Jiat Lee
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Correspondence to Mee Hoong See.

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Lee, C.J., Lai, L.L., See, M.H. et al. Breaking the Barrier: A Study on Multi-drug Resistance in Breast Abscess at an Academic Malaysian Hospital. World J Surg 47, 2743–2752 (2023). https://doi.org/10.1007/s00268-023-07108-z

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  • DOI: https://doi.org/10.1007/s00268-023-07108-z

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