Postpartum mastitis in the breastfeeding women and antimicrobial resistance of responsible pathogens in Ukraine: results a multicenter study

Abstract

The aim: To obtain the prevalence of mastitis in the breastfeeding women and antimicrobial resistance of responsible pathogens in Ukraine. 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: 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. 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.