Current Microbiology of surgical site infections associated with breast cancer surgery

Surgical site infections (SSI) are the most common complications of breast cancer surgery. The authors identified 35 cases of SSI in the M.D. Anderson Cancer Center (Houston, TX) over a 7-month study period. Monomicrobial infections predominated (69%) with Staphylococcus aureus being isolated most often. A wide variety of gram-positive and gram-negative organisms were isolated from the 31% of polymicrobial infections, suggesting the need for broad-spectrum coverage at least until culture results become available. Although all S aureus isolates were susceptible to vancomycin (minimal inhibitory concentration [MIC] ≤ 2.0 μg/mL), 63% of methicillin- susceptible isolates and 82% of methicillin-resistant isolates had MIC values of ≥ 1.0 μg/mL for this agent, indicating the need for alternative therapeutic agents. The organisms were susceptible to trimethoprim/ sulfamethoxazole, rifampin, linezolid, daptomycin, and tigecycline.