Project title
corynebacterium在非孕期/非哺乳期乳腺炎的角色: DNA檢測及抗生素藥物動力學
Internal ID
MOST106-2314-B002-183
Principal Investigator
Start Date
August 1, 2017
End Date
July 12, 2018
Investigators
Organizations
Partner Organizations
The Role of Corynebacterium in Non-Puerperal, Non-Gestation Mastitis: a Cohort Study by Dna Sequence and Therapeutic Drug Monitor = corynebacterium在非孕期/非哺乳期乳腺炎的角色: DNA檢測及抗生素藥物動力學
Keywords
乳腺炎
原位雜合(In Situ Hybridization
ISH)
治療性藥物濃度檢驗
棒狀桿菌屬
(Corynebacterium)
(Corynebacterium)
mastitis
corynebacterium
drug monitoring
Description
Mastitis is one of the most common complications seen in postpartum women, with a prevalence rate of 5-33%. However, increasing evidence pointed out the mastitis can appeared among the non-gestational and non-puerperal stage. Granulomatous mastitis (GM) may related to autoimmune process and some studies suggest some type of GM may be associated with corynebacterium infection. However, corynebacterium was usually regarded as normal flora and the pathogenic role in mastitis is not clearly defined. From our preliminary cohort study in a tertially hospital, we had noted the patients who had corynebacterium identified in mastitis were associated with longer treatment duration and higher recurrence rate. Thus, we hypothesis that the corynebacterium can be true pathogen in mastitis. The reason for poor treatment outcome or recurrence may be related to inappropriate treatment or low antibiotics concentration in the lipotropic breast tissue. Through a prospective cohort, we aim to enroll non-gestational and non-puerperal mastitis patients. In situ DNA hybridization method will be used to identify possible corynebacterium infection in mastitis tissue. Culture of the pus and 16S rRNA gene sequencing will be used to detect and confirmation of the corynebacterium. Possible virulence factors among corynebacterium spp., including SpaC, PknG, and NanH will be detected in aspirated pus sample by PCR. The tissue and pus from the infection site will be biopsy/aspirated to measure the local antibiotics concentration by HPLC method, compared with serum antibiotics level. We also aim to extend the prior retrospective mastitis cohort and focus on corynebacterium associated mastitis and compare the treatment outcome between the appropriatedly treated group (corynebacterium susceptible antibiotics) and non-appropriatedly treated group. Through the study, we can provide more evidence whether corynebacterium can be the true pathogen for mastitis. If the study result support our hypothesis, we will further suggest that the corynebacterium should be identified to the species level and provide antimicrobial susceptibility test result to facilitate the treatment, reduce repeated debridement, and prevent recurrent mastitis.