Breast Implant Infections: Is Cefazolin Enough?

Feldman, Evan M.; Kontoyiannis, Dimitrios P.; Sharabi, Safa E.; Lee, Edward; Kaufman, Yoav; Heller, Lior

doi:10.1097/prs.0b013e3181e5f7ff

Cited by 71 publications

(61 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Approximately 1 to 2.5% of breast prostheses develop infection (654)(655)(656)(657). Estimates for the proportion of these infections due to S. aureus range from 0 to 75% (655,658,659). For example, in a multicenter retrospective cohort of 106 patients with confirmed or suspected breast prosthesis infection, Feldman et al found that 68% of the 31 culture-positive breast implants grew S. aureus, 37% of which grew MRSA (658).…”

Section: Infections Involving Other Prosthetic Devicesmentioning

confidence: 99%

“…Estimates for the proportion of these infections due to S. aureus range from 0 to 75% (655,658,659). For example, in a multicenter retrospective cohort of 106 patients with confirmed or suspected breast prosthesis infection, Feldman et al found that 68% of the 31 culture-positive breast implants grew S. aureus, 37% of which grew MRSA (658). In contrast, none of the 65 culture-confirmed silicone breast infections reported by Ahn et al grew S. aureus (659).…”

Section: Infections Involving Other Prosthetic Devicesmentioning

confidence: 99%

See 1 more Smart Citation

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

et al. 2015

View full text Add to dashboard Cite

SUMMARY Staphylococcus aureus is a major human pathogen that causes a wide range of clinical infections. It is a leading cause of bacteremia and infective endocarditis as well as osteoarticular, skin and soft tissue, pleuropulmonary, and device-related infections. This review comprehensively covers the epidemiology, pathophysiology, clinical manifestations, and management of each of these clinical entities. The past 2 decades have witnessed two clear shifts in the epidemiology of S. aureus infections: first, a growing number of health care-associated infections, particularly seen in infective endocarditis and prosthetic device infections, and second, an epidemic of community-associated skin and soft tissue infections driven by strains with certain virulence factors and resistance to β-lactam antibiotics. In reviewing the literature to support management strategies for these clinical manifestations, we also highlight the paucity of high-quality evidence for many key clinical questions.

show abstract

Section: Infections Involving Other Prosthetic Devicesmentioning

confidence: 99%

Section: Infections Involving Other Prosthetic Devicesmentioning

confidence: 99%

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

et al. 2015

View full text Add to dashboard Cite

show abstract

“…The endogenous breast flora can reach deeper tissues through breast ducts or during surgery. According to different studies [11,12], the microorganism most frequently observed is coagulase-negative staphylococci but in a recent single retrospective review [28], 67% of implant infections were due to S. aureus, with methicillin resistance in 68% of these cases. In the same study, Gram-negative bacteria were reported in only 6% of infections.…”

Section: Acute Infectionsmentioning

confidence: 99%

“…The onset time of infections is different for saline implants and silicone implants: saline implant infections occur within 8 weeks (on average 4 weeks), while silicone implant infections occur within 26 weeks (on average 13 weeks) [27]. The earlier onset of saline implant infections may be linked to contamination during implant filling [28]. After augmentation mammaplasty, 0.8% of patients are affected by late infections.…”

Section: Late Infectionsmentioning

confidence: 99%

“…Cytological and immunohistochemical evaluations are necessary in unclear diagnostic cases, which raise the problem of differential diagnosis between subclinical infection and malignancies such as anaplastic large cell lymphoma [52]. The most frequent infections are caused by bacteria of endogenous skin flora, particularly coagulase-negative staphylococci and S. aureus [28]. Before culture and antibiogram, empiric therapy with vancomycin is recommended, based on the high number of infections due to beta-lactam resistant pathogens, among which are methicillinresistant S. aureus and coagulase-negative staphylococci.…”

Section: Diagnosis and Managementmentioning

confidence: 99%

See 1 more Smart Citation

Infections in breast implants: a review with a focus on developing countries

Rubino

Brongo

Pagliara

et al. 2014

J Infect Dev Ctries

View full text Add to dashboard Cite

The risk of surgical site infection is always present in surgery; the use of prosthetic materials is linked to an increased possibility of infection. Breast augmentation and breast reconstruction with implants are gaining popularity in developing countries. Implant infection is the main complication related to breast aesthetic and reconstructive surgery. In the present paper, we reviewed the current microbiological knowledge about implant infections, with particular attention to risk factors, diagnosis, clinical management, and antibiotic prophylaxis, focusing on reports from developing countries. After breast aesthetic surgery, up to 2.9% of patients develop a surgical site infection, with an incidence of 1.7% for acute infections and 0.8% for late infections. The rate of surgical site infection after post-mastectomy breast reconstruction is usually higher, ranging from 1% to 53%. The clinical features are not constant, and bacterial culture with antibiogram is the gold standard for diagnosis and for identification of antibiotic resistance. While waiting for culture results, empiric therapy with vancomycin and extendedspectrum penicillins or cephalosporins is recommended. Some patients require removal of the infected prosthesis. The main methods to bring down the risk of infection are strict asepsis protocol, preoperative antibiotic prophylaxis, and irrigation of the surgical pocket and implant with an antibiotic solution.Key words: breast implant infections; acute infections; late infections; fungal infections; rare infections. EpidemiologyImplant infection is the main complication related to breast aesthetic and reconstructive surgery [1]. After breast aesthetic augmentation, up to 2.9% of women are affected by infection [2], with an incidence of 1.7% for acute infections versus an incidence of 0.8% for late infections, as confirmed by retrospective cohort studies with long-term follow-ups [1]. In developing countries, this problem is even more prevalent; surgery has a 50% rate of possible complications, of which infection is the main complication [3]. The rate of surgical site infection after post-mastectomy breast reconstruction is usually higher, ranging from 1% to 53% [4,5]. In breast reconstruction, a higher rate of infection was reported with expander implants compared to reconstruction with autologous tissue such as latissimus dorsi flaps [6]. The highest rates were found in women undergoing immediate reconstruction [4]. The reported number of infections after mammary augmentation and reconstruction is lower than the real incidence, because of the lack of a surveillance network of patients based on long-time follow-ups. The economic commitment for management of implant infections is significant. Kirkland et al. [7] reported an increase of hospital permanence for surgical site infection of 6.5 days, with related health care costs. In the United States, health care costs for surgical site infection after breast surgery were estimated to be about $4,091 [7], or $574 in the outpatient setting [9]...

show abstract

Polydimethyl siloxane based nanocomposites with antibiofilm properties for biomedical applications

Sankar

Murthy

Das

et al. 2016

J. Biomed. Mater. Res.

View full text Add to dashboard Cite

Polydimethyl siloxane (PDMS) is an excellent implant material for biomedical applications, but often fails as it is prone to microbial colonization which forms biofilms. In the present study CuO, CTAB capped CuO, and ZnO nanoparticles were tested as nanofillers to enhance the antibiofilm property of PDMS against Staphylococcus aureus and Escherichia coli. In general S. aurues (Gram positive and more hydrophobic) favor PDMS surface than glass while E. coli (Gram negative and more hydrophilic) behaves in a reverse way. Incorporation of nanofillers renders the PDMS surface antibacterial and reduces the attachment of both bacteria. These surfaces are also not cytotoxic nor show any cell damage. Contact angle of the material and the cell surface hydrophobicity influenced the extent of bacterial attachment. Cell viability in biofilms was dependent on the antimicrobial property of the nanoparticles incorporated in the PDMS matrix. Simple regression relationships were able to predict the bacterial attachment and number of dead cells on these nanocomposites. Among the nanocomposites tested, PDMS incorporated with CTAB (cetyl trimethylammonium bromide)-capped CuO appears to be the best antibacterial material with good cyto-compatibility. V C 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 00B: 000-000, 2016.

show abstract

Breast Implant Infections: Is Cefazolin Enough?

Cited by 71 publications

References 16 publications

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

Infections in breast implants: a review with a focus on developing countries

Polydimethyl siloxane based nanocomposites with antibiofilm properties for biomedical applications

Contact Info

Product

Resources

About