Non-diphtheriae Corynebacteria Causing Breast Abscess in Nonlactating Females-Seeking to Avoid Pitfalls in Diagnosis of Chronic Breast Infections Through Diagnostic Stewardship

Authors

  • Raman Sardana Department of Microbiology, Indraprastha Apollo Hospitals, New Delhi
  • Hena Butta Department of Microbiology, Indraprastha Apollo Hospitals, New Delhi
  • Kirti Gilotra Department of Microbiology, Indraprastha Apollo Hospitals, New Delhi
  • Leena Mendiratta Department of Microbiology, Indraprastha Apollo Hospitals, New Delhi
  • Pankaj Baweja Department of Pathology, Indraprastha Apollo Hospitals, New Delhi
  • Ramesh Sarin Department of Pathology, Indraprastha Apollo Hospitals, New Delhi

DOI:

https://doi.org/10.21276/apalm.3162

Keywords:

Breast abscess, Corynebacteria, MALDITOF MS, Diphtheroids, Lipophilic Corynebacteria

Abstract

Background: Consideration of non-diphtheriae Corynebacteria as an infective organism in mastitis, is usually neglected. So, infections due to Corynebacterium species may remain undiagnosed or misdiagnosed. The aim of our study was to focus on non-diphtheriae Corynebacterium as causative organisms in breast infections using scientific logic and technology of Matrix Assisted Laser Desorption Ionisation Time of Flight Mass Spectrometry (MALDITOF MS) to categorize the isolates upto species level. The clinical correlation and response to management especially targeted antimicrobials was also recorded.

Methods: All the consecutive pus/tissue samples from Breast abscess received during study period were processed as per the standard guidelines. The identification of the isolate was done by automated methods.  The cytopathological/histopathological and clinical details of the patients with infection due to Corynebacterium sp. were recorded and analyzed.

Results: Out of 52 non-duplicate samples, five showed growth of non-diphtheriae Corynebacteria.  These were identified as C. kroppenstedtii and C. amycolatum. The antimicrobial susceptibility testing showed 100% susceptibility to Amoxicillin-clavulanate, Tetracycline, Vancomycin and Linezolid for all the five isolates. Histopathological examination was suggestive of chronic inflammatory mastitis/Granulomatous mastitis.

Conclusion: Non diphtheriae Corynebacteria particularly lipophilic Corynebacteria have a predilection to cause infections of breast tissue and Breast abscess which may mimic as tubercular abscess or chronic non-specific mastitis leading to unnecessary usage of antimicrobials. So, these isolates from breast tissue/pus should not be ignored rather definitely identified. This would also ensure diagnostic stewardship.

References

AbdelHadi MSA, Huda A. Bukharie HA. Breast infections in non-lactating women. J Family Community Med 2005;12:133-7.

Boakes E, Woods A, Johnson N, Kadoglou. Breast Infection: A Review of Diagnosis and Management Practices. Eur J Breast Health 2018; 14: 136-143.

Le Flèche-Matéos A, Berthet N, Lomprez F, Arnoux Y, Le Guern A.S, Leclercq I, et al. Recurrent breast abscesses due to Corynebacterium kroppenstedtii, a human pathogen uncommon in Caucasian women. Case Rep. Infect. Dis., 2012 (2012), p. 120968

Kutsuna S, Mezaki K, Nagamatsu M, Kunimatsu J, Yamamoto K, Fujiya Y, et al.Two cases of granulomatous mastitis caused by Corynebacterium kroppenstedtii infection in nulliparus young women with hyperprolactinemia. Intern. Med., 54 (2015); 1815-1818

Poojary I, Kurian A, V A J, Devapriya JD, M A T. Corynebacterium species causing breast abscesses among patients attending a tertiary care hospital in Chennai, South India.Infect Dis (Lond). 2017 Jul;49(7):528-531

Ang LMN, Brown H. Corynebacterium accolens Isolated from Breast Abscess: Possible Association with Granulomatous Mastitis. JOURNAL OF CLINICAL MICROBIOLOGY 2007;45(5): 1666–1668.

Wolfrum A, Kümmel S, Theuerkauf I et al. Granulomatous Mastitis: A Therapeutic and Diagnostic Challenge. Breast Care 2018;13:413–418.

Saraiya, Nidhi; Corpuz, Marilou. Corynebacterium kroppenstedtii: a challenging culprit in breast abscesses and granulomatous mastitis, Current Opinion in Obstetrics and Gynecology: October 2019 - Volume 31 - Issue 5 - p 325-332

Al Nazer MA. Idiopathic granulomatus lobular mastitis. A forgotten clinical diagnosis. Saudi Med J. 2003 Dec;24(12):1377-80. PMID: 14710288.

Yu HJ , Deng H, Ma J , Huang SJ , Yang JM , Huang YF , Mu XP , Zhang L, Wang Q. Clinical metagenomic analysis of bacterial communities in breast abscesses of granulomatous mastitis. International Journal of Infectious Diseases 2016;53:30-33.

Butta H, Pasha F, Dawar R, et al. Corynebacterium amycolatum causing breast abscess- an infecting Diphtheroid with a difference. Annals of Pathology and Laboratory Medicine 2017; 4(4):C-128-30

Dobinson HC, Anderson TP, Chambers ST et al. Antimicrobial treatment options for granulomatous mastitis caused by Corynebacterium species. J. Clin. Microbiol., 53 (2015), pp. 2895-2899.

Downloads

Published

09-07-2022

How to Cite

1.
Sardana R, Butta H, Gilotra K, Mendiratta L, Baweja P, Sarin R. Non-diphtheriae Corynebacteria Causing Breast Abscess in Nonlactating Females-Seeking to Avoid Pitfalls in Diagnosis of Chronic Breast Infections Through Diagnostic Stewardship. Ann of Pathol and Lab Med [Internet]. 2022 Jul. 9 [cited 2024 Dec. 5];9(6):A115-120. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/3162

Issue

Section

Original Article