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, 史友權, 司怡然, 等. 耐甲氧西林金黃色葡萄球菌流行病學特征的研究進展. 大連醫科大學學報, 2013, 35(2): 183-187.
3.	李方, 楊霞. 急性乳腺炎患者金黃色葡萄球菌 296 株的耐藥變遷分析.中國社區醫師, 2015, 31(26): 10-11.
4.	張偉珍, 楊雪靜. 101 例細菌性乳腺炎患者的臨床病原分析. 浙江中醫藥大學學報, 2011, 35(2): 164-167.
5.	中華人民共和國衛生部. 多重耐藥菌醫院感染預防和控制技術指南. 藥物不良反應雜志, 2011, 13(2): 108-109.
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8.	王育瑛, 楊瑋, 呂凌云, 等. 107 例乳腺膿液的病原菌分布及耐藥性分析. 中國微生態學雜志, 2014, 26(12): 1437-1440.
9.	梁璐, 陳冰. 乳腺膿腫分離到葡萄球菌的鑒定和藥敏分析. 現代醫藥衛生, 2009, 25(11): 1671-1672.
10.	吳孟超, 吳在德.黃家駟外科學. 第7版.北京: 人民衛生出版社, 2008: 1152-1153.
11.	葉玉梅, 秦士新, 周坤. 乳腺膿腫治療的可行性研究. 重慶醫學, 2015, 44(11): 1551- 1552.
12.	陳少勇, 韋富中, 李楚瓊. 乳腺穿刺與切開引流治療乳腺膿腫的臨床療效. 實用臨床醫學, 2015, 16(3): 42-43.
13.	顧兵, 朱榮峰, 郭建鋒, 等.超聲引導下穿刺沖洗治療乳腺膿腫的臨床價值. 中國介入影像與治療學, 2011, 8(3): 186-188.
14.	張斌. 乳腺膿腫超聲引導穿刺治療與傳統手術治療效果對比. 實用診斷與治療雜志, 2007, 21(6): 458-459.
15.	閆智清, 馬祥君, 王青, 等. 哺乳期急性乳腺炎的致病菌分布及其藥敏特點. 中國綜合臨床, 2014, 30(7): 732-734.
16.	李瑞香, 郭巨江, 廖洪葉, 等. 哺乳期乳腺膿腫病原菌分布及耐藥性研究. 臨床合理用藥雜志, 2012, 5(3C): 11-12.
17.	吳健寧, 吳佳音. 243 例哺乳期急性乳腺炎病原菌分布及耐藥性分析. 中國衛生檢驗雜志, 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.	張淑敏, 朱熠, 陳旭, 等. 耐甲氧西林金黃色葡萄球菌的臨床感染特點及耐藥特性. 中華醫院感染學雜志, 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, 謝志紅. 產后乳腺膿腫患者 MRSA 感染的臨床分析及對策. 中國婦幼保健, 2014, 29(17): 2697-2698.
24.	陳少全, 王烈, 鄒忠東, 等. 粘貼式負壓沖吸器在乳腺膿腫切開引流治療中的應用. 第二軍醫大學學報, 2007, 28(5): 562-564.
25.	施勇, 盧淑嬌. 3 種方法治療乳腺膿腫的比較. 中國中西醫結合外科雜志, 2011, 17(2): 223-225.
26.	汪潔, 高雅軍, 高海鳳, 等. 膿腔置管沖洗與切開引流治療乳腺膿腫的比較. 中國微創外科雜志, 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, 史友權, 司怡然, 等. 耐甲氧西林金黃色葡萄球菌流行病學特征的研究進展. 大連醫科大學學報, 2013, 35(2): 183-187.
3. 李方, 楊霞. 急性乳腺炎患者金黃色葡萄球菌 296 株的耐藥變遷分析.中國社區醫師, 2015, 31(26): 10-11.
4. 張偉珍, 楊雪靜. 101 例細菌性乳腺炎患者的臨床病原分析. 浙江中醫藥大學學報, 2011, 35(2): 164-167.
5. 中華人民共和國衛生部. 多重耐藥菌醫院感染預防和控制技術指南. 藥物不良反應雜志, 2011, 13(2): 108-109.
6. 陳孝平, 汪建平. 外科學. 第8版. 北京: 人民衛生出版社, 2013: 253-254.
7. 夏永生, 陳莉杰, 李剛. 哺乳期與非哺乳期乳腺膿腫病原菌分布及耐藥性比較. 中國衛生檢驗雜志, 2016, 26(12): 1808-1809.
8. 王育瑛, 楊瑋, 呂凌云, 等. 107 例乳腺膿液的病原菌分布及耐藥性分析. 中國微生態學雜志, 2014, 26(12): 1437-1440.
9. 梁璐, 陳冰. 乳腺膿腫分離到葡萄球菌的鑒定和藥敏分析. 現代醫藥衛生, 2009, 25(11): 1671-1672.
10. 吳孟超, 吳在德.黃家駟外科學. 第7版.北京: 人民衛生出版社, 2008: 1152-1153.
11. 葉玉梅, 秦士新, 周坤. 乳腺膿腫治療的可行性研究. 重慶醫學, 2015, 44(11): 1551- 1552.
12. 陳少勇, 韋富中, 李楚瓊. 乳腺穿刺與切開引流治療乳腺膿腫的臨床療效. 實用臨床醫學, 2015, 16(3): 42-43.
13. 顧兵, 朱榮峰, 郭建鋒, 等.超聲引導下穿刺沖洗治療乳腺膿腫的臨床價值. 中國介入影像與治療學, 2011, 8(3): 186-188.
14. 張斌. 乳腺膿腫超聲引導穿刺治療與傳統手術治療效果對比. 實用診斷與治療雜志, 2007, 21(6): 458-459.
15. 閆智清, 馬祥君, 王青, 等. 哺乳期急性乳腺炎的致病菌分布及其藥敏特點. 中國綜合臨床, 2014, 30(7): 732-734.
16. 李瑞香, 郭巨江, 廖洪葉, 等. 哺乳期乳腺膿腫病原菌分布及耐藥性研究. 臨床合理用藥雜志, 2012, 5(3C): 11-12.
17. 吳健寧, 吳佳音. 243 例哺乳期急性乳腺炎病原菌分布及耐藥性分析. 中國衛生檢驗雜志, 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. 張淑敏, 朱熠, 陳旭, 等. 耐甲氧西林金黃色葡萄球菌的臨床感染特點及耐藥特性. 中華醫院感染學雜志, 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, 謝志紅. 產后乳腺膿腫患者 MRSA 感染的臨床分析及對策. 中國婦幼保健, 2014, 29(17): 2697-2698.
24. 陳少全, 王烈, 鄒忠東, 等. 粘貼式負壓沖吸器在乳腺膿腫切開引流治療中的應用. 第二軍醫大學學報, 2007, 28(5): 562-564.
25. 施勇, 盧淑嬌. 3 種方法治療乳腺膿腫的比較. 中國中西醫結合外科雜志, 2011, 17(2): 223-225.
26. 汪潔, 高雅軍, 高海鳳, 等. 膿腔置管沖洗與切開引流治療乳腺膿腫的比較. 中國微創外科雜志, 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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