None of the other bacteria listed are common in breast infections, though all are common pathogens. Preventative measures include proper patient selection, preoperative MRSA management when carriers are suspected, routine presurgery chlorhexidine washes, proper antibiotic timing presurgery and continuation of antibiotics in implant reconstruction cases for at least 24 hours (though the optimal treatment duration has not yet been determined). In reconstructive cases, the infection rate averages 6% and the explantation rate 3% (range, 1.5 to 8%). More than 300,000 breast implant procedures are performed each year in the United States. Other breast pathogens include Escherichia coli, Propionibacterium, and Corynebacterium. In patients without systemic symptoms, wash out and new implant placement can be an option in carefully selected and counseled patients. In the case of breast implant infections, if there is not rapid improvement on antibiotic therapy, or if significant systemic symptoms develop (vital sign instability, high white blood cell count, fever, renal impairment), then surgical washout and device removal is mandatory. Dual coverage is often recommended in severe infections. It is a gram negative rod, and common antibiotic treatments include advanced β-lactams (piperacillin, ceftazidime), carbapenems, quinolones, and aminoglycosides. It is common in hospitalized or immunocompromised patients, as well as patients with foreign body devices such as catheters or implants.
epidermidis, Pseudomonas aeruginosa is among the the next most common sources of breast infections.
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