Analysis Of Pathogenesis Of Non-puerperal Mastitis By Corynebacterium Kroppenstedtii Infection And Antibiotic Susceptibility Results

Objective:Non-puerperal mastitis(NPM)is a rare benign breast inflammatory disease,which mainly includes Granulomatous lobular mastitis(GLM)and Periduct mastitis(PDM).At present,the pathogenesis is not clear.Autoimmune response is often considered to play a major role in the disease,and most patients often have prolonged symptoms,which seriously affects the quality of life of women,due to treatment difficulties.And incidence of the disease has increased rapidly since the 21 st century.Therefore,it is urgent to further understand the pathogenesis and personalized treatment of NPM.At present,many studies and cases have detected Corynebacterium kroppenstedtii(CK)in specimens,and the immune stimulation effect of CK has also been confirmed,Th17 cells,Interleukin-17(IL-17)is the main cytokine of Th17 cells that are closely related to the body ’ s autoimmune response,and the increase of IL-17 levels in serum of patients with NPM has also been reported.In this study,he potential mechanism about the pathogenic role of CK infection in NPM and antibiotics in the treatment of CK-related NPM were investigated by detecting the bacteria and serum IL-17 in NPM patients and drug sensitivity results.Methods:In this study,patients with non-puerperal mastitis or benign non-inflammatory lesions diagnosed by pathology in our hospital from October 2020 to October-2021 were enrolled as the research objects,and they were taken as the case group and the control group.Patients with skin ulcer were excluded,and 40 cases in the final case group and 11 cases in the control group were selected.Serum IL-17 and bacterial tests were performed on all selected subjects.The results of bacterial culture were observed,and the positive rates of bacterial culture in the case group and the control group were calculated according to culture results.Serum IL-17 levels were collected and compared among the control group,CK-positive patients and patients without bacterial infection.The clinical data of patients in the case group were collected to analyze the related factors of CK infection in NPM patients.The single factor with statistically significant differences was included in the multivariate analysis.The susceptibility test was further performed on the cultured CK strains,and the susceptibility rates of different antibiotics were calculated.Statistical software SPSS26.0 was used for data analysis.Variance analysis was used for comparison of enumeration data.Chi-square test or Fisher exact probability method was used for measurement data.After one-way analysis,logistic regression model was used for multi-factor analysis of statistically significant one-way factors.P < 0.05 indicated statistically significant difference.Results:Three patients with skin ulcer were excluded.Finally,40 patients in the case group and 11 patients in the normal group were included.The difference in bacterial detection rate between the case group and the control group was statistically significant(P =0.002),and Corynebacterium kroppenstedtii was the dominant bacterium.Serum IL-17 levels were not exactly the same among the control group,CK positive patients and non-bacterial infection patients(P<0.001).Univariate analysis showed that breast abscess,antibiotic use history,fever / elevated hemogram were correlated with CK infection in NPM patients,and the difference was statistically significant(P < 0.05).Multivariate analysis showed that serum IL-17 was related to CK infection in NPM patients,and the difference was statistically significant(P < 0.05).The results of drug sensitivity test showed that the sensitivity rates of vancomycin,gentamicin and linezolid were 100 %;the sensitivity of meropenem was 78.9 %,ciprofloxacin was 78.9 %,ceftriaxone was 57.8 %.Penicillin 0.0 %,clindamycin 5.3 %,erythromycin 5.3 %.Conclusion:Bacterial infection is closely related to NPM,CK is the main pathogen;breast abscess formation,history of antibiotic use,fever / hemogram elevation and serum IL-17 elevation may be related to CK infection in NPM patients.The serum IL-17 of NPM patients infected with CK was significantly increased;according to the above results,CK may play a pathogenic role in NPM by activating certain immune effects.According to the analysis of clinical antibiotic medication norms and drug sensitivity results,lipophilic quinolones may be the preferred empirical drug for CK-related NPM patients.