Application of continuous drainage with intravenous catheter in breast abscess infected by methicillin resistant staphylococcus aureus_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANG Yanwu , LÜ Yidong , NIU Yaodong , YAN Wenjun , FENG Aiqiang

Department of Mammary Surgery, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R.China;

Corresponding author：

ZHANG Yanwu, Email: zyw555@126.com

Keywords：

breast abscess; methicillin resistant staphylococcus aureus; continuous drainage; puncture drainage

DOI：

10.7507/1007-9424.201609044

Video：

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Objective To observe and evaluate the efficacy of continuous drainage with intravenous catheter in the treatment of breast abscess infected by methicillin resistant staphylococcus aureus (MRSA) and to explore the best treatment methods. Methods Sixty cases of breast abscess infected by MRSA were retrospectively analyzed. The patients were divided into continuous drainage group and puncture drainage group according to the treatment. Continuous drainage with 14G intravenous catheter and intermittent aspiration with 20 mL syringe were performed to treat the breast abscesses in the continuous drainage group (n=36) and puncture drainage group (n=24), respectively. Meanwhile, sensitive antibiotics were used according to the results of susceptibility test. The therapeutic effects of the 2 groups were compared. Results There were no significant differences in baseline data between continuous drainage group and puncture drainage group (P>0.05). There was no significant differences of cure rate between the two groups (P=0.717). Compared with the puncture drainage group, the continuous drainage group showed shorter period of time to heal the breast abscess (P=0.001), shorter period of time to control the ache (P=0.038), less punctures (P<0.001) and more daily volume of drainage (P<0.001). No significant differences were found in the period of time to control the fever between the two groups (P=0.127). Conclusions Continuous drainage with intravenous catheter can shorten the course of disease, reduce the suffering of patients, reduce the difficulty of hospital infection prevention and control. It’s an ideal choice for the treatment of breast abscess infected by MRSA.

Citation： ZHANG Yanwu, LÜ Yidong, NIU Yaodong, YAN Wenjun, FENG Aiqiang. Application of continuous drainage with intravenous catheter in breast abscess infected by methicillin resistant staphylococcus aureus. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(4): 478-481. doi: 10.7507/1007-9424.201609044 Copy

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2.	王斌, 史友权, 司怡然, 等. 耐甲氧西林金黄色葡萄球菌流行病学特征的研究进展. 大连医科大学学报, 2013, 35(2): 183-187.
3.	李方, 杨霞. 急性乳腺炎患者金黄色葡萄球菌 296 株的耐药变迁分析.中国社区医师, 2015, 31(26): 10-11.
4.	张伟珍, 杨雪静. 101 例细菌性乳腺炎患者的临床病原分析. 浙江中医药大学学报, 2011, 35(2): 164-167.
5.	中华人民共和国卫生部. 多重耐药菌医院感染预防和控制技术指南. 药物不良反应杂志, 2011, 13(2): 108-109.
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8.	王育瑛, 杨玮, 吕凌云, 等. 107 例乳腺脓液的病原菌分布及耐药性分析. 中国微生态学杂志, 2014, 26(12): 1437-1440.
9.	梁璐, 陈冰. 乳腺脓肿分离到葡萄球菌的鉴定和药敏分析. 现代医药卫生, 2009, 25(11): 1671-1672.
10.	吴孟超, 吴在德.黄家驷外科学. 第7版.北京: 人民卫生出版社, 2008: 1152-1153.
11.	叶玉梅, 秦士新, 周坤. 乳腺脓肿治疗的可行性研究. 重庆医学, 2015, 44(11): 1551- 1552.
12.	陈少勇, 韦富中, 李楚琼. 乳腺穿刺与切开引流治疗乳腺脓肿的临床疗效. 实用临床医学, 2015, 16(3): 42-43.
13.	顾兵, 朱荣峰, 郭建锋, 等.超声引导下穿刺冲洗治疗乳腺脓肿的临床价值. 中国介入影像与治疗学, 2011, 8(3): 186-188.
14.	张斌. 乳腺脓肿超声引导穿刺治疗与传统手术治疗效果对比. 实用诊断与治疗杂志, 2007, 21(6): 458-459.
15.	闫智清, 马祥君, 王青, 等. 哺乳期急性乳腺炎的致病菌分布及其药敏特点. 中国综合临床, 2014, 30(7): 732-734.
16.	李瑞香, 郭巨江, 廖洪叶, 等. 哺乳期乳腺脓肿病原菌分布及耐药性研究. 临床合理用药杂志, 2012, 5(3C): 11-12.
17.	吴健宁, 吴佳音. 243 例哺乳期急性乳腺炎病原菌分布及耐药性分析. 中国卫生检验杂志, 2011, 21(6): 1533-1534.
18.	Shorr AF. Epidemiology of staphylococcal resistance. Clin Infect Dis, 2007, Suppl 3: S171-S176.
19.	Schmitz GR.How do you treat an abscess in the era of increased community-associated methicillin- resistant Staphylococcus aureus ( MRSA). J Emerg Med, 2011, 41(3): 276-281.
20.	张淑敏, 朱熠, 陈旭, 等. 耐甲氧西林金黄色葡萄球菌的临床感染特点及耐药特性. 中华医院感染学杂志, 2012, 22 (3): 601-603.
21.	Elder EE, Brennan M.Nonsurgical management should be first line therapy for breast abscess. World J Surg, 2010, 34(9): 2257-2258.
22.	Christensen AF, Al-Suliman N, Nielsen KR, et al. Ultrasound-guided drainage of breast abscesses: results in 151 patients. Br J Radiol, 2005, 78(927): 186-188.
23.	巢蕙怡, 谢志红. 产后乳腺脓肿患者 MRSA 感染的临床分析及对策. 中国妇幼保健, 2014, 29(17): 2697-2698.
24.	陈少全, 王烈, 邹忠东, 等. 粘贴式负压冲吸器在乳腺脓肿切开引流治疗中的应用. 第二军医大学学报, 2007, 28(5): 562-564.
25.	施勇, 卢淑娇. 3 种方法治疗乳腺脓肿的比较. 中国中西医结合外科杂志, 2011, 17(2): 223-225.
26.	汪洁, 高雅军, 高海凤, 等. 脓腔置管冲洗与切开引流治疗乳腺脓肿的比较. 中国微创外科杂志, 2007, 7(4): 354-355.

1. Haamann F. MRSA as an occupational disease: a case series. Int Arch Occup Environ Health, 2012, 84(3): 259-266.
2. 王斌, 史友权, 司怡然, 等. 耐甲氧西林金黄色葡萄球菌流行病学特征的研究进展. 大连医科大学学报, 2013, 35(2): 183-187.
3. 李方, 杨霞. 急性乳腺炎患者金黄色葡萄球菌 296 株的耐药变迁分析.中国社区医师, 2015, 31(26): 10-11.
4. 张伟珍, 杨雪静. 101 例细菌性乳腺炎患者的临床病原分析. 浙江中医药大学学报, 2011, 35(2): 164-167.
5. 中华人民共和国卫生部. 多重耐药菌医院感染预防和控制技术指南. 药物不良反应杂志, 2011, 13(2): 108-109.
6. 陈孝平, 汪建平. 外科学. 第8版. 北京: 人民卫生出版社, 2013: 253-254.
7. 夏永生, 陈莉杰, 李刚. 哺乳期与非哺乳期乳腺脓肿病原菌分布及耐药性比较. 中国卫生检验杂志, 2016, 26(12): 1808-1809.
8. 王育瑛, 杨玮, 吕凌云, 等. 107 例乳腺脓液的病原菌分布及耐药性分析. 中国微生态学杂志, 2014, 26(12): 1437-1440.
9. 梁璐, 陈冰. 乳腺脓肿分离到葡萄球菌的鉴定和药敏分析. 现代医药卫生, 2009, 25(11): 1671-1672.
10. 吴孟超, 吴在德.黄家驷外科学. 第7版.北京: 人民卫生出版社, 2008: 1152-1153.
11. 叶玉梅, 秦士新, 周坤. 乳腺脓肿治疗的可行性研究. 重庆医学, 2015, 44(11): 1551- 1552.
12. 陈少勇, 韦富中, 李楚琼. 乳腺穿刺与切开引流治疗乳腺脓肿的临床疗效. 实用临床医学, 2015, 16(3): 42-43.
13. 顾兵, 朱荣峰, 郭建锋, 等.超声引导下穿刺冲洗治疗乳腺脓肿的临床价值. 中国介入影像与治疗学, 2011, 8(3): 186-188.
14. 张斌. 乳腺脓肿超声引导穿刺治疗与传统手术治疗效果对比. 实用诊断与治疗杂志, 2007, 21(6): 458-459.
15. 闫智清, 马祥君, 王青, 等. 哺乳期急性乳腺炎的致病菌分布及其药敏特点. 中国综合临床, 2014, 30(7): 732-734.
16. 李瑞香, 郭巨江, 廖洪叶, 等. 哺乳期乳腺脓肿病原菌分布及耐药性研究. 临床合理用药杂志, 2012, 5(3C): 11-12.
17. 吴健宁, 吴佳音. 243 例哺乳期急性乳腺炎病原菌分布及耐药性分析. 中国卫生检验杂志, 2011, 21(6): 1533-1534.
18. Shorr AF. Epidemiology of staphylococcal resistance. Clin Infect Dis, 2007, Suppl 3: S171-S176.
19. Schmitz GR.How do you treat an abscess in the era of increased community-associated methicillin- resistant Staphylococcus aureus ( MRSA). J Emerg Med, 2011, 41(3): 276-281.
20. 张淑敏, 朱熠, 陈旭, 等. 耐甲氧西林金黄色葡萄球菌的临床感染特点及耐药特性. 中华医院感染学杂志, 2012, 22 (3): 601-603.
21. Elder EE, Brennan M.Nonsurgical management should be first line therapy for breast abscess. World J Surg, 2010, 34(9): 2257-2258.
22. Christensen AF, Al-Suliman N, Nielsen KR, et al. Ultrasound-guided drainage of breast abscesses: results in 151 patients. Br J Radiol, 2005, 78(927): 186-188.
23. 巢蕙怡, 谢志红. 产后乳腺脓肿患者 MRSA 感染的临床分析及对策. 中国妇幼保健, 2014, 29(17): 2697-2698.
24. 陈少全, 王烈, 邹忠东, 等. 粘贴式负压冲吸器在乳腺脓肿切开引流治疗中的应用. 第二军医大学学报, 2007, 28(5): 562-564.
25. 施勇, 卢淑娇. 3 种方法治疗乳腺脓肿的比较. 中国中西医结合外科杂志, 2011, 17(2): 223-225.
26. 汪洁, 高雅军, 高海凤, 等. 脓腔置管冲洗与切开引流治疗乳腺脓肿的比较. 中国微创外科杂志, 2007, 7(4): 354-355.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of continuous drainage with intravenous catheter in breast abscess infected by methicillin resistant staphylococcus aureus

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