POSTPARTUM MASTITIS IN THE BREASTFEEDING WOMEN AND ANTIMICROBIAL RESISTANCE OF RESPONSIBLE PATHOGENS IN UKRAINE: RESULTS A MULTICENTER STUDY
Aidyn G. Salmanov, Serhii E. Savchenko, Kyrylo Chaika, Alla D. Vitiuk, Iana Ruban, O.А. Dyndar, Д. М. Железов, Ludmila I. Vorobey, Л. М. Семенюк, N. V. Hetsko, Olga Tsmur, Lidiya V. Suslikova, T.R. Nykoniuk, Ye.Ye. Shunko, Halyna V. Beketova, Lyudmila V. Manzhula, В.В. Курочка, Esmira R. Abbasova
Abstract
OBJECTIVE: The aim: To obtain the prevalence of mastitis in the breastfeeding women and antimicrobial resistance of responsible pathogens in Ukraine. PATIENTS AND METHODS: Materials and methods: A retrospective multicenter cohort study was based on surveillance data for Postpartum Mastitis and included 18,427 breastfeeding women's who gave birth in 11 regional hospitals of Ukraine. RESULTS: Results: 22.6% breastfeeding women's were found to have breast infections. Among these patients, 11.6% breast abscess and 88.4% mastitis were observed. Of the total cases breast infections, 74.8% were detected after hospital discharge. The rate of healthcare-associated mastitis was 8.6%. The predominant pathogens were: Staphylococcus aureus (23.6%), Escherichia coli (19.4%), Enterobacter spp. (11.9%), Staphylococcus epidermidis (10.7%), Klebsiella spp. (8.7%), Pseudomonas aeruginosa (4.8%), Enterococcus faecalis (4.8%), and Proteus mirabilis (4.6%). The overall proportion of methicillin-resistance was observed in 27.9% of S. aureus (MRSA) and 24.3% of S. epidermidis (MRSE). Of the total methicillin-resistance strains, 74.8% of MRSA and 82.1% of MRSE is community-acquired, were detected after hospital discharge. Vancomycin resistance was observed in 9.2% of isolated enterococci. Carbapenem resistance was identified in 7.3% of P.aeruginosa isolates. Resistance to third-generation cephalosporins was observed in 8.8% Klebsiella spp. and E.coli 9.1% isolates. CONCLUSION: Conclusions: Mastitis in the breastfeeding women in Ukraine requires medical attention it is common, and a lot of cases are caused by pathogens resistant to antibiotics. Optimizing the management and empirical antimicrobial therapy may reduce the burden of mastitis, but prevention is the key element.