Mastitis and Methicillin-Resistant Staphylococcus Aureus (MRSA): The Calm Before the Storm?

Background: Post-partum mastitis is a common infection in breastfeeding women, with an incidence of 9.5–16% in recent literature. Over the past decade, community-acquired methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a significant pathogen in soft-tissue infections presenting to the emergency department. The incidence of mastitis caused by MRSA is unknown at this time, but likely increasing. Objectives: We review the data on prevention and treatment of mastitis and address recent literature demonstrating increases in MRSA infections in the post-partum population and how we should change our practices in light of this emerging pathogen. Case Report: We present a case of simple mastitis in a health care worker who failed to improve until treated with antibiotics appropriate for a MRSA infection. Conclusion: Recent evidence suggests that just as MRSA has become the prominent pathogen in other soft-tissue infections, mastitis is now increasingly caused by this pathogen. Physicians caring for patients with mastitis need to be aware of this bacteriologic shift to treat appropriately.